NHTSA’s Office of EMS and AHRQ Supporting Systematic Review of Prehospital Blood Transfusion

The National Highway Traffic Safety Administration’s (NHTSA) Office of EMS and the Agency for Healthcare Research and Quality (AHRQ) is facilitating the development of a systematic review on the feasibility, effectiveness, and safety of blood and blood product transfusions administered in the prehospital setting. This review will be conducted by one of AHRQ’s designated Evidence-based Practice Centers, which are tasked with developing evidence reports to inform clinical decision-making and actions. The agencies are seeking feedback to assist in the development of the systemic review.

The results of the systemic review will inform future prehospital care evidence-based guidelines, protocols and decision-making processes for state and local EMS agencies. Specifically, the systemic review will explore key questions about the comparative benefits and harms of:

• Low-titer group O whole blood transfusion versus component therapy.
• Low-titer group O whole blood transfusion versus fluid resuscitation.
• Component blood therapy versus fluid resuscitation.

Additionally, the review will assess how these benefits and harms are influenced by various factors, including prehospital EMS protocols, patient characteristics and EMS system characteristics (such as air medical versus ground ambulance services).

NHTSA’s Office of EMS and AHRQ are also seeking feedback on future research priorities to address current evidence gaps surrounding prehospital hemostatic resuscitation and blood product transfusion. The systemic review aims to identify facilitators and barriers to implementing effective prehospital blood transfusion programs, considering aspects such as EMS agency costs, reimbursement, logistics, partnerships with blood banks and medical oversight.

The deadline to submit feedback is 11:59 p.m. ET on Tuesday, June 18. Additional information is available online.