The Power of Rapid Decision-Making and Early Blood Access in Pre-Hospital Trauma Care

Author: Ettienne Coetser, ROCKET Clinical Base Manager: Jhb

On the evening of 6 May 2025, ROCKET HEMS was activated for a time-sensitive inter-hospital transfer involving a young patient who had sustained a penetrating neck injury. The initial handover from the referring facility painted a stark picture: the patient was experiencing profound blood loss, and crucially, no whole blood or blood products were available on site - a dangerous resource shortfall with potentially fatal implications. Early blood access in pre-hospital trauma care is critical to patient survival.

Equipped with freeze-dried plasma - and driven by patient-centred thinking - the ROCKET team went a step further, showcasing the adaptability that defines high-acuity emergency care.

Innovative Early Blood Access in Pre-Hospital Trauma Care: The ROCKET Team's Proactive Approach

In South Africa’s pre-hospital environment, the administration of blood products remains rare. ROCKET, however, is equipped with freeze-dried plasma, a valuable intervention that is also not yet standard in many emergency medical systems. But in this case, the ROCKET team went a step further—an example of the dynamic, patient-focused thinking that defines high-acuity emergency medicine.

Recognising the urgency and critical nature of the haemorrhagic shock, the ROCKET crew made the bold but calculated decision to divert to the receiving hospital first, where they collected two units of packed red blood cells before proceeding to the referring facility. This proactive approach is still relatively uncommon in South African pre-hospital care, yet it reflects an evolving understanding of trauma physiology and the undeniable benefits of early blood administration in the field.

Pre-Hospital Blood Administration: A Life-Saving Intervention for Trauma Patients

Evidence increasingly supports the pre-hospital use of blood products for trauma patients. Studies have demonstrated improved survival outcomes, reduced mortality rates, and better physiological stabilisation in patients suffering from massive haemorrhage when blood is administered before hospital arrival. In short, blood saves lives—and administering it early can mean the difference between life and death.

When the ROCKET team arrived at the referring facility, they were met with a rapidly deteriorating patient. The collected blood was administered immediately on scene, stabilising the patient sufficiently for air transfer. The helicopter then departed for the Level 1 trauma centre in Johannesburg, ensuring the patient reached definitive care with optimised odds for survival and recovery.

Enhancing Trauma Care: The Critical Role of Adaptive Decision-Making and Blood Access

This mission exemplifies the irreplaceable value of rapid, adaptive decision-making in pre-hospital care. It also highlights the growing need for improved access to blood products in trauma systems—especially in settings where time, distance, and limited resources challenge survival.

At its core, this operation reflects what emergency medical care should always strive to be: responsive, resourceful, and relentlessly patient-centred. As trauma systems continue to evolve, it is this mindset—anchored in foresight, agility, and clinical excellence—that will continue to save lives when seconds matter most.