Spotlight on Research

Time to treatment is an important factor in the management of patients with traumatic haemorrhage, but the common perception that blood may be superior to saline in the prehospital setting is yet to be proven. RePHILL was a randomised controlled trial conducted across four critical care services within the UK, that studied whether the use of prehospital blood (packed red blood cells (PRBC) and lyophilised plasma (lyoplas) reduced mortality and improved tissue perfusion in comparison with sodium chloride (NaCl) 0.9% alone.

Participants were included in this study if they were ≥16 years old and suffering traumatic injury and hypotension presumed to be due to traumatic haemorrhage. Hypotension was defined as a lack of radial pulse or systolic blood pressure <90 mmHg. Eligibility was determined by the prehospital medical teams and treatment was randomised through the use of identical sealed treatment packs prepared with either PRBC-LyoPlas or 0.9% NaCl. Consent was deferred until the emergency had passed.