A 68-year-old male sustained a large-caliber gunshot wound (GSW) to the lower left leg, causing an open fracture with severe arterial bleeding. Upon EMS arrival, the patient was found pale, cool, and diaphoretic, displaying signs of profound hemorrhagic shock. Initial assessment revealed a Glasgow Coma Scale (GCS) score of 7 with intermittent loss of consciousness, no measurable blood pressure, weak bilateral radial pulses, and a heart rate of 110 bpm.
Recognizing the urgency of his need for rapid blood replacement, paramedics immediately initiated resuscitation with O-positive whole blood using the LifeFlow device. An entire 500mL unit of blood was infused in 2 minutes and 30 seconds via a 16-gauge IV catheter in the patient’s left antecubital fossa. This is significantly faster than conventional gravity or pressure bag methods.
The impact of the rapid resuscitation was immediately evident, with improved skin color, blood pressure of 142/94 mmHg, heart rate of 118 bpm, and a respiratory rate of 20 breaths per minute. The patient’s neurological status also markedly improved, with a post-transfusion GCS of 15. He became fully alert, oriented to person, place, time, and events, and was able to recall details of the incident clearly.
Although a second unit of blood was prepared and ready for immediate infusion, clinical evaluation revealed stable and sustained improvement, negating the need for additional blood administration. Concurrent treatments included administration of 1 gram each of calcium chloride and tranexamic acid (TXA), 2 grams of Ancef, and supplemental oxygen delivered via nasal cannula at 6 liters per minute.
The patient was transferred expediently from the scene to an air medical transport team within 4 minutes. Paramedics involved reported that LifeFlow significantly improved their capability to rapidly deliver lifesaving whole blood, highlighting the device’s simplicity, efficiency, and superior control compared to traditional fluid resuscitation methods. The paramedic reported, “The infusion of whole blood to the hypovolemic patient in shock was quick and easy. The [LifeFlow] is simple, effective and allows the medic to control the flow at the rate necessary. Using Life Flow compared to a pressure bag, for example, makes a world of a difference.”
This case underscores the critical advantage of rapid whole blood administration with LifeFlow in pre-hospital management of severe trauma, potentially preventing the need for other advanced procedures such as endotracheal intubation, and facilitating significant improvements in patient outcomes and survival potential.