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Missed prehospital transfusions in paediatric trauma

Missed Opportunities for Prehospital Transfusion in Pediatric Trauma
Prehospital Emergency Care · 2026-10-19 · Added 7 October 2026

Analysis of 1.66 million US paediatric trauma EMS activations found only 0.1% of children with a positive shock index — those plausibly benefiting from blood — received a prehospital transfusion, suggesting major underuse.

Study type

Registry

Design

Retrospective national EMS registry cohort

Participants

1,663,601 paediatric trauma EMS activations; 363,844 with positive shock index

Main finding

Only 287 of 363,844 shock-index-positive children (0.1%) received prehospital transfusion; 10 of 468 (2%) children with EMS-attended arrest got a hospital transfusion

Caveat

Positive shock index is a crude surrogate for haemorrhagic shock, and NEMSIS coding may undercount transfusions

Bottom line

Hypothesis-generating

Learning goal

Recognise early signs of haemorrhagic shock in paediatric trauma where prehospital blood transfusion may be warranted.

More

• Topic: Paediatrics
• Daily scan: 7 October 2026

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