By mapping where severe trauma and the need for blood transfusions overlap, researchers show how cities can more accurately deploy scarce blood supplies and deliver faster, potentially lifesaving care to patients who need it most.
Research: Geographic mapping using in-hospital massive transfusion data as a method for prehospital blood management of trauma patients. Image credit: Sergey kolesnikov/Shutterstock.com
According to a study published in the Journal of the Journal, American College of Surgeonscan be identified by geomapping High-need zone for prehospital whole blood (PHWB) transfusions. This improves resource allocation and More timely access to blood transfusion in hemorrhagic shock.
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Whole blood transfusions maintain the balance of red blood cells, plasma, and platelets. Such blood transfusions are routinely performed in the military and in many civilian facilities. Whole blood has a superior logistics profile and leads to better clinical outcomes through multiple mechanisms.
PHWB is primarily required for major trauma, which is associated with more impoverished areas where trauma care is lacking. However, blood banks come with costs, supply chain issues, and storage issues.
Emergency medical services (EMS) vehicles must be loaded with blood with proper storage conditions, further increasing investment. Additionally, the PHWB program relies on close collaboration with hospitals, blood donors, and city authorities.
These factors may help explain why prehospital blood transfusions were used in less than 1% of ground emergency services for patients with hemorrhagic shock in 2024. New technologies such as geospatial mapping should be considered to improve EMS care.
Geomapping to map trauma hotspots
Geomapping, the identification of patterns from spatial data, is used for multiple tasks in EMS. For example, we have reduced ambulance dispatch times by up to 20%. This could potentially be used to predict trauma hotspots and deploy PHWB and other resources in strategic locations. This is consistent with the ongoing shift to data-driven decision-making in emergency medicine.
Using activation of massive transfusion protocols as a marker
In the current study, the authors evaluated the potential of massive transfusion protocol (MTP) activation as a marker of the need for PHWB. MTP refers to the transfusion of three or more units of blood within one hour of arrival. They used trauma registry data from Omaha and Lincoln, Nebraska, to identify all occasions when massive transfusion protocols (MTPs) were invoked. This was evaluated as a surrogate for the need for PHWB transfusion.
The researchers also obtained historical control data on assaults and motor vehicle fatalities from police and transportation databases. In both towns, penetrating trauma accounted for approximately 84 percent of all injuries in Omaha and 78 percent in Lincoln, and the average age of victims was much younger than for blunt trauma. More than 50% of penetrating trauma cases involved Black or Latino individuals. In both towns, more than 90% of cases affected men.
The total time from EMS dispatch to arrival at the trauma bay was longer for penetrating trauma than for blunt trauma. For example, in Omaha, the median total emergency time for penetrating trauma was 34 minutes, and in Lincoln, it was 26 minutes.
Geographic mapping revealed that trauma incidents were concentrated in downtown locations in both towns. This may be related to socio-economic factors, poor environmental conditions, increased crime, unequal access to healthcare, and increased rates of trauma. EMS times for penetrating trauma cases were long in both towns, demonstrating the potential value of targeted resource placement, and the authors suggest that placing trauma care resources near Omaha’s high-incidence areas could benefit the community.
Both cities showed a statistically significant association between trauma incidence and MTP activation, although there was a stronger correlation between trauma incidence and MTP activation in Omaha but not in Lincoln. The fire department handles EMTs in both towns. Geomapping identified areas of greatest need and provided data to reduce healthcare disparities in prehospital trauma care.
The authors show that MTP activation can serve as a proxy for PHWB needs, potentially reducing reliance on external datasets such as police and traffic data that are not uniformly available across municipalities. This work only requires access to a trauma center registry that meets National Trauma Data Bank (NTDB) standards and sends data to the American College of Surgeons Trauma Quality Programs (TQP) data center. This ensures that geomapping can be used to identify areas of high need across a variety of settings, although implementation may vary depending on local EMS structures and resources.
Based on previous studies cited by the authors and not in this analysis, administration of PHWB plus other medications increases prehospital time by up to 5 minutes, while reducing time to first transfusion by 19 minutes and reducing in-hospital mortality by 22%. The survival benefit is especially significant when it takes more than 20 minutes to reach a hospital, as in these towns.
Research limitations
This study did not find a strong linear correlation between Lincoln’s MTP activation rate and trauma, probably because the data were too limited. Smaller towns may require further research or alternative documentation methods. Additionally, the findings may not be completely generalizable to cities with different trauma patterns or multiple non-fire-based EMS systems.
Geographically mapped MTP data are strongly correlated with known trauma, supporting MTP activation as a surrogate marker of the need for PHWB. This provides a new way for cities to plan their PHWB programs by determining high-need zones and ensuring fair and cost-effective allocation of scarce resources.
This study also highlights the potential of geomapping as a useful tool for the equitable and future strategic deployment of prehospital interventions. Near real-time configuration.
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