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Traumatic injuries account for 37 million emergency department visits yearly in the United States alone, with over six million deaths attributed to trauma-related causes.^1,2 Though the nature of every incident and the patient’s injuries may be unique, hemorrhage is consistently one of the leading causes of death from trauma.³

Prompt recognition of shock symptoms following severe bleeding and timely transport to a trauma center are critical for improving the patient’s chance of survival. However, waiting to replace substantial blood volume deficits until the patient arrives at the hospital can be disastrous. Maintaining adequate blood pressure to ensure optimal perfusion to vital organs, including the brain, significantly reduces mortality rates and represents one of the most effective pre-hospital interventions.⁴ Unfortunately, many first responders don’t have the right equipment to perform sufficient rapid resuscitation during transport.

The following case illustrates the effectiveness of the LifeFlow PLUS rapid infuser in administering blood products and fluids to a severely hypotensive trauma patient during an airlift transfer.

Case Presentation

A senior-aged male patient suffered massive multisystem trauma, including multiple long bone fractures, and was experiencing profound hypotension. Despite a negative eFast assessment, the patient’s condition was rapidly deteriorating, and signs of severe shock were present. The team determined the immediate need for helicopter transportation between facilities for more advanced care.

Vital sign assessment revealed a heart rate of 118, blood pressure of 50/palp, SPO2 of 92%, and profoundly delayed capillary refill. The patient was also mottled, cold to the touch, and had feeble central pulses.

Mass transfusion protocol (MTP) was initiated prior to transport, and the patient received four units of blood products. However, the transport team quickly identified that the patient remained in severe shock and initiated additional volume resuscitation during transit.

Management

The flight nurse used the LifeFlow PLUS handheld rapid infuser to begin an infusion of 500 mL of whole blood. An additional 200 mL of normal saline was then infused with the LifeFlow device.

Immediately following the intervention, the patient’s vital signs improved. Assessment revealed a heart rate of 102, blood pressure of 104/72, and improved mentation. The patient spent 22 minutes in transport before arriving at the destination hospital and did not require any additional infusions during the flight.

Discussion

Following a significant trauma, prioritizing the replacement of lost fluid and blood volume to maintain adequate blood pressure is imperative. Swift intervention with blood and crystalloid fluid administration often delineates the fine line between life and death for the patient.⁴

In situations when every minute of delay increases the patient’s risk of mortality, standard methods of blood infusion are frequently too slow. This is particularly true for trauma patients whose vascular access may be restricted to small-gauge IVs or IO lines.

The LifeFlow PLUS rapid infuser enables faster fluid resuscitation and can deliver a unit of blood up to three times faster than a pressure bag.⁵ Its compact design and user-friendly, one-handed operation make it an ideal choice for first responders navigating constrained spaces in urgent situations.

The transport nurse in this case applauded the LifeFlow PLUS for surpassing the speed of both a pressure bag and the push-pull method for delivering blood products to a patient in critical need.

LifeFlow is a critical tool for first responders. It is uniquely capable of meeting the demands of pre-hospital volume replacement in trauma patients to promptly address severe hypotension and improve patient outcomes.