Evidence map›Paper›PMID 40713702›Full record

Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2025

Bleeding resuscitation in the ambulance service, an observational study of standard care in Sweden.

G Skallsjö, G Sandström, J G Sato Folatre, A M Harstad, A Åström Victorén, E Sömoen, E Höglund, J Haglund, J Sköld, T Bergström and 4 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

G SkallsjöHelicopter Emergency Medical Service, Västra Götalandsregionen, Gothenburg, Sweden. gabriel.skallsjo@gu.se.
G SandströmDepartment of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J G Sato FolatreHelicopter Emergency Medical Service, Västra Götalandsregionen, Gothenburg, Sweden.
A M HarstadDepartment of Anaesthesiology and Intensive Care, Central Hospital of Karlstad, Karlstad, Sweden.
A Åström VictorénDepartment of Emergency Medical Service, Region Jönköping, Jönköping, Sweden.
E SömoenDepartment of Ambulance Care, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
E HöglundDepartment of Ambulance Care, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
J HaglundDepartment of Emergency Medical Service, Västra Götalandsregionen, Trollhättan, Sweden.
J SköldDepartment of Emergency Medical Service, Region Norrbotten, Luleå, Sweden.
T BergströmHelicopter Emergency Medical Service, Region Norrbotten, Gällivare, Sweden.
C MagnussonDepartment of Molecular and Clinical Medicine, Gothenburg University, Gothenburg, Sweden.
K WibringDepartment of Ambulance and Prehospital Care, Region Halland, Sweden.
B RomlinDepartment of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
A WikmanClinical Immunology and Transfusion Medicine, Department of Medicine Huddinge, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe ambulance service in Sweden has most often only crystalloids as resuscitation, even though restrictive use of clear fluids in bleeding patients is recommended. The aim of this study was to describe the treatment and outcome of bleeding patients treated by the ambulance service.

methodsThis was a prospective observational multi-center study. Ambulance organizations in six different regions were invited to participate, each of them for a period of six months. Adult bleeding patients where fluid resuscitation with crystalloids was initiated by the ambulance service was consecutively included. Prehospital data on type of bleeding, mechanism and severity of injury, vital signs, estimated bleeding volume, treatment and transport time was collected from the ambulance service. Results from laboratory tests and data of transfusion requirements and mortality were obtained from the medical records, after hospital admission.

results181 patients were resuscitated with crystalloid fluids by the ambulance service and were included in the study. Gastrointestinal bleeding was the cause of fluid resuscitation in 48% of the patients and bleeding due to trauma in 23%. A high proportion of the patients (41%) had a coagulopathy upon admission at the hospital, defined as prothrombin time > 1,2, platelet count < 150 × 10

conclusionIn this study gastrointestinal bleeding and trauma were the leading causes of severe prehospital bleeding. Blood loss over 500 mL and Shock Index above 1.3 were key predictors of poor outcome, highlighting the potential benefit of earlier blood product administration.

trial registrationClinical trial number: Not applicable.

Indexed as

AmbulancesEmergency Medical ServicesFluid TherapyHemorrhageResuscitationAdultAgedCrystalloid SolutionsFemaleHumansIsotonic SolutionsMaleMiddle AgedProspective StudiesSwedenCrystalloid SolutionsIsotonic SolutionsAmbulance servicePrehospital coagulopathyPrehospital fluid resuscitationShock indexTransfusion with blood productsTrauma induced coagulopathy

Identifiers

PMID40713702
PMCPMC12291521

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.