This study is investigating different blood transfusion treatments for patients with severe bleeding before they get to hospital.
Every year, uncontrolled bleeding due to
major injury accounts for more than 2 million deaths worldwide and 4,500 deaths in England.
Blood transfusion is an essential part of the treatment for severe bleeding, and any delay to starting transfusion can reduce the chances of survival. In the UK patients are often transfused blood at the scene of an incident, before they arrive at hospital.
Transfusion may involve different blood components, red blood cells (important for carrying oxygen around the body), plasma (contains essential proteins to help blood clot) and platelets (small cells that are essential for blood clot formation).
Most UK air ambulances treat bleeding patients with a combination of red blood cells and plasma, which come in separate bags. Platelets are stored differently to other products and are more difficult to carry on air ambulances, so are only given after arrival at hospital.
However, carrying separate blood component bags introduces logistical challenges due to the additional weight the team needs to carry; increased complexity as several bags may need to be given to each patient; and a potential delay in transferring patients to hospital.
Whole blood contains red cells, plasma and platelets all in one bag, as taken from a blood donor. Giving a blood transfusion of all of the components in a single bag could overcome these challenges.
In this study, one group of patients will be given transfusions of red blood cells and plasma. The other group of patients will receive transfusions of whole blood.
The effects of the two different treatments will be compared by looking at survival in the two groups and the amount of blood needed over the first 24 hours after injury. We are also investigating how you are doing up to three months after your injury.
At the end of the study we will determine which of the transfusion types is better (or whether there is no difference between them) so that more patients in the future will get the best treatment.
