The management of major haemorrhage and shock has evolved significantly over recent years, and will continue to do so. Addressing acute traumatic coagulopathy (ATC) and endotheliopathy of trauma (EoT) is central to this, starting on-scene. In order to understand these processes and eventually test interventions directed at them in the pre-hospital environment we must firstly have a system for measuring them and, in turn, establish some background statistics for this patient population.
MedSTAR is the pre-hospital and medical retrieval arm of the South Australian Ambulance Service. Its scope includes the treatment of critically injured patients on-scene before transfer to a trauma centre. It is therefore well-placed to investigate the pathological processes that take place soon after a traumatic event, as well as to effect early interventions aimed at improving mortality and morbidity in trauma patients.
This pilot study entails the collection of venous blood samples from pre-hospital trauma patients, at the earliest opportunity, and pairing them with samples taken on arrival in the Emergency Department. Its aims are to establish a system for investigating the pathology of early trauma and to estimate population characteristics that can be used to plan further studies, including use of novel interventions.
Dr Paul Lambert, Adelaide Anaesthetic Services
Dr Daniel Ellis, Royal Adelaide Hospital
Both investigators also at MedSTAR, Rescue, Retrieval and Aviation Services, Adelaide, South Australia.
The project was awarded $A9,000 funding through the ANZCA research grants program for 2023.