Exsanguination remains the leading cause of preventable deaths among victims of trauma with nearly half of these patients dying in the prehospital setting. Prehospital blood resuscitation is also clinically indicated for selected patients who hemorrhage from medical conditions (e.g. post-partum hemorrhage, abdominal bleeds). Individuals requiring critical care in the field in many locations in the US do not have access to prehospital blood transfusions due to reimbursement policies and scope of practice...
Exsanguination remains the leading cause of preventable deaths among victims of trauma with nearly half of these patients dying in the prehospital setting. Prehospital blood resuscitation is also clinically indicated for selected patients who hemorrhage from medical conditions (e.g. post-partum hemorrhage, abdominal bleeds). Individuals requiring critical care in the field in many locations in the US do not have access to prehospital blood transfusions due to reimbursement policies and scope of practice limitations.
To discuss this, host Rob Lawrence welcomes Dr Jon Krohmer to this edition of NAEMT Radio. Dr Krohmer identifies the issues of whole blood availability, clinical scope of practice and reimbursement and suggests outcomes and solutions. Dr Krohmer also talks about the work of the Prehospital Blood Transfusion Initiative Coalition and its survey of the agencies currently delivering pre-hospital blood administration.
Resources:
Prehospital Blood Transfusion Initiative Coalition: About Us | Prehospital Blood Transfusion Initiative Coalition | Improving Prehospital Blood Transfusion (prehospitaltransfusion.org)
Prehospital Blood Transfusion Initiative Coalition – briefing to the National EMS Advisory Council - August 2003: Pre-Hospital Transfusion Reimbursement Working Group Meeting with NAEMT & Other Key Stakeholders Crystal Gateway Marriott March 31, 2023 (ems.gov)
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About our Guest
Jon R. Krohmer, M.D., FACEP, FAEMS has recently retired as the Director of the NHTSA Office of EMS in the Department of Transportation and as the EMS Medical Director for the Caroline County (MD) Department of Emergency Services. He also served as the NHTSA Acting Associate Administrator for Research and Program Development from October 2018 to January 2020. Previously, he was the principal deputy assistant secretary for DHS Office of Health Affairs and DHS deputy chief medical officer. He began serving in that position as a member of the Senior Executive Service (SES) with DHS in September 2006 and served as the acting assistant secretary for health affairs and chief medical officer from August 2008 to August 2009. Dr. Krohmer was an attending physician and director of emergency medical services (EMS), emergency medicine residency and Department of Emergency Medicine at the Spectrum Health Butterworth Campus in Grand Rapids, MI, associate professor of emergency medicine at the College of Human Medicine at Michigan State University and EMS medical director of Kent County Emergency Medical Services and was the medical director for the West Michigan Metropolitan Medical Response System and the Region 6 Consortium. Dr. Krohmer received his undergraduate degree at Ferris State College, School of Pharmacy in Big Rapids, Mich. in 1976 and is a graduate of the University of Michigan Medical School (1983) in Ann Arbor, Mich. He completed his emergency medicine residency (1986) and EMS Fellowship (1987) at Wright State University in Dayton, Ohio. He is board certified in emergency medicine and emergency medical services. His current interests include EMS systems design and medical oversight, mass gathering events and EMS clinical support
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