Clinical Presentation: A 26-year-old male sustained severe injuries in a motorcycle collision with a pickup truck. When Cobb County Fire and Emergency Services arrived on scene, the patient was noted to have extensive facial injuries and severe trauma to the right upper and lower extremities. The team found him apneic with no carotid pulse, and non-reactive pupils. The monitor revealed ventricular fibrillation. CPR was immediately initiated, along with defibrillation, airway management using an iGel, and tibial IO access for medication and fluid administration.
Interventions: Blood products stored in a Delta cooler arrived at the scene and were delivered rapidly and warmed using LifeFlow and the QinFlow Warrior:
- 500 ml PRBCs via tibial IO over 3 minutes
- 320 ml plasma via tibial IO over 3 minutes
- 390 ml PRBCs via an 18-gauge left AC IV over 2 minutes
- 320 ml plasma via the same IV over 2 minutes
Calcium Gluconate along with two grams of Tranexamic Acid (TXA) were administered and flushed using approximately 20-30 ml normal saline via IO access. Additional fluids included intermittent normal saline flushes and administration to support hemodynamic stability.
Patient Response and Outcome: Significant improvement was noted after the first unit of PRBCs, with return of a weak carotid pulse. After additional warmed plasma and PRBCs the patient regained strong carotid and radial pulses, a measurable blood pressure, positive ETCO₂, and exhibited purposeful movement by attempting to pull out the iGel.
Transport and Hospital Care: During the 9-minute transport to Wellstar Kennestone Regional Medical Center, the patient remained hemodynamically stable. Immediate hospital interventions included rapid sequence intubation (RSI), ECMO cannulation, diagnostic scans, and multiple surgeries addressing severe facial injuries, extremity fractures, spinal injuries, and carotid artery dissection. Following extensive rehabilitation, the patient was discharged home neurologically intact.
Clinician Feedback: The paramedic team emphasized that LifeFlow significantly enhanced the speed and effectiveness of blood product delivery compared to traditional methods, notably improving patient outcomes in this critical scenario. The paramedic reported, “I personally have administered blood as a flight medic by gravity and squeezing the bag. It’s so much better using the LifeFlow, very quick and efficient. I was able to get the blood products on board faster in this critical patient in traumatic arrest. Getting the blood on board in a fast, timely matter made the difference in this patient.”