Page 30 - JSOM Winter 2025

TABLE 2 Patient Characteristics Grouped by Ongoing Hypotension Post pRBC
Group, no. (%)*
SBP <90 post-HEMS pRBC; SBP >90 post-HEMS pRBC;
Characteristic n = 34 n = 31
Age, y, mean (SD) 41 (18.3) 47 (18.1)
Male 28 (82) 21 (68)
Injury Severity Score, mean (SD) 29 (14) 25 (14)
Prehospital Index, mean (SD) 13.7 (6.5) 9.7 (6.5)
Blunt injury 24 (70.6) 23 (74)
Pre-trauma center cardiac arrest 7 (21) 1 (3)
Mechanism of injury
Motor vehicle crash 24 (70.6) 20 (64.5)
Stab/gunshot wound 8 (23.4) 8 (25.8)
Auger, crush, fall 2 (6) 3 (9.7)
HEMS, mean (SD) [n]
Worst HR (bpm) 110 (29) [28 ] 107 (28) [30 ]
†
†
Worst SBP (mmHg) mean (SD) [n] 74 (17) [28 ] 83 (17) [30 ]
†
‡
Worst Shock Index 1.6 (0.6) [28 ] 1.4 (0.6) [30 ]
†
†
GCS
3–8 15 (44) 8 (26)
9–12 2 (6) 4 (13)
13–15 17 (50) 19 (61)
Base excess, mean (SD) [n] –13 (6) [18 ] –9.7 (6.4) [16 ]
‡
‡
‡
Lactate, mean (SD) [n] 6.2 (4.1) [18 ] 5.3 (4.1) [16 ]
‡
‡
Hemoglobin, mean (SD) [n] 100 (24.2) [21 ] 106 (24) [16 ]
‡
Crystalloid (mL)
Pre-HEMS, mean (SD) 2,304 (1,741) 1,853 (1,755)
HEMS, mean (SD) 951 (897) 897 (902)
HEMS pRBC units, mean (SD) 2.5 (1.2) 1.95 (1.2)
Prehospital tranexamic acid 30 (88) 27 (87)
Prehospital vasopressor use 9 (26) 3 (10)
Intubation
Pre-HEMS 11 (32) 7 (23)
By HEMS 12 (35) 7 (23)
Biologic parameters measured in ED, mean (SD)
Fibrinogen concentration, g/L 1.5 (0.94) 2.4 (0.94)
INR 1.5 (0.5) 1.2 (0.5)
Platelet count, 10 /L 164 (73) 202 (74)
9
Hemoglobin, g/L 129 (21) 127 (21)
Lactate, mmol/L 6.6 (4.1) 4.5 (4.1)
Base deficit, mmol/L –9.5 (45.3) –6 (5.4)
ED massive hemorrhage protocol activation 22 (65) 13 (42)
Required: angiography/surgery 2 (6) / 29 (94) 5 (16) / 26 (84)
14-day mortality: hemorrhage and multiorgan failure 7 (20.5) 1 (3)
Mortality other cases 7 (20.5) 1 (3)
‡
SBP<90 w/ ground EMS, no. (%) [n] 14 (41) [32 ] 11 (35) [29 ]
‡
SBP<90 after >250mL IV fluid 34 (100) 20 (65)
SBP<90 post first unit of HEMS pRBC 34 (100) 0 (0)
Interfacility/scene call 17 (50) / 17 (50) 13 (42) / 18 (58)
Injury time to HEMS arrival, min, mean (SD) [n] 113 (95) [33 ] 155 (96) [28 ]
‡
‡
Injury time to ED arrival, min, mean (SD) [n] 194 (113) [33 ] 252 (114) [28 ]
‡
‡
HEMS 1st pRBC to ED arrival time, min, mean (SD) 52 (30) 45 (31)
Total HEMS flight time, min, mean (SD] 38 (25) 39 (24)
Total HEMS care time, min, mean (SD] 73 (55) 102 (55)
*Unless otherwise specified.
† Excluded cardiac arrest with HEMS cases in calculation.
‡ Excluded other data points due to missing data.
ED = emergency department; EMS = emergency medical services; HEMS = Helicopter EMS; INR = international normalized ratio; pRBC =
packed red blood cells; SBP = systolic blood pressure.
28 | JSOM Volume 25, Edition 4 / Winter 2025