Case Summary
Ridgeview Ambulance responded to a motor vehicle collision involving a 25-year-old female who was trapped beneath the dashboard and required a prolonged extrication. Upon EMS arrival, the crew suspected severe hemorrhagic shock from suspected pelvic and femur fractures and found that the patient was minimally responsive with profound hypotension, decreasing heart rate, and impending cardiovascular collapse.
Initial Presentation
On initial assessment, the patient exhibited signs of severe hemorrhagic shock:
- Blood pressure: 45/21 mmHg
- Heart rate: 98 bpm
- Shock index: 2.1
- Mental status: Minimally responsive with altered mental status
- Other findings: Low SpO₂ with dampened waveform
Given the patient’s profound hypotension and suspected internal bleeding, the crew elected to begin blood transfusion immediately.
Two units of O-positive packed red blood cells were rapidly delivered over approximately seven minutes using LifeFlow through 18-gauge peripheral IV access. The blood was actively warmed using the QinFlow Warrior throughout the transfusion.
Patient Response
The patient demonstrated a rapid physiologic response during blood administration.
Following transfusion:
- Blood pressure: Increased to 116/45 mmHg
- Heart rate: 112 bpm
- Shock index: Improved from 2.1 to 0.9
- Mental status: Improved significantly and the patient began asking for help
By ED arrival the patient’s hemodynamics and mentation had improved markedly, allowing the receiving team to focus on definitive management rather than resuscitation. The crew noted that using LifeFlow for blood delivery was easier and faster than other methods.
This case demonstrates how rapid prehospital blood transfusion can quickly improve perfusion in patients with traumatic hemorrhagic shock. By delivering two units of warmed blood during transport, the EMS crew restored hemodynamic stability, improved the patient’s mental status, and created the opportunity to focus on other critical interventions while expediting transfer to definitive trauma care.