Broome JM, Nordham KD, Piehl M, et al. Faster refill in an urban emergency medical services system saves lives: A prospective preliminary evaluation of a prehospital advanced resuscitative care bundle. J Trauma Acute Care Surg. 2024;96(5):702-707.

• First study ever to demonstrate a mortality benefit for prehospital blood in urban EMS

• The San Antonio EMS study of over 500 patients showed improvement in mortality in the ED, but could not show that more people made it out of the hospital alive

• Odds ratio for mortality of 0.2, which means that patients who received the ARC bundle had a 20% risk of dying compared to those who didn’t receive blood

• Scene shock index was higher for the ARC patients, but was normal at ED arrival

• In contrast, for control patients SI was lower at the scene but had not corrected as much as in the blood group

• Also, this study showed a dramatic reduction in prehospital intubation rate when blood was delivered early (12% vs 1.6%)

• This mortality improvement was achieved despite a 3 minute increase in total transport time (13 minutes in controls vs 16 minutes in ARC patients)