Thanks @FireMedic40NJ it was a total privilege to join Mike Carunchio and @HandtevyMD on Okayest Medic! We discussed the recent @AcademicEmerMed article suggesting there isn’t enough evidence for blood in ground EMS, and our editorial challenging the authors. onlinelibrary.wiley.com/doi/… onlinelibrary.wiley.com/doi/… If you can’t access our letter, here’s the basic summary: Schoenfeld & colleagues analyzed three RCT’s on prehospital blood including: PAMPer - an air medical trial of plasma for trauma COMBAT - an urban EMS study of thawed plasma, and RePHILL - a UK air medical trial comparing blood products to crystalloid Only PAMPer showed some benefit during 40 minute transports, and in RePHILL resuscitation wasn’t actually started until about 50 min after EMS arrival. None evaluated the “advanced resuscitative care” package of blood, TXA, and calcium currently administered fast-paced ground EMS agencies, which is the new damage control resuscitation: immediate hemorrhage control where possible, basic airway support, and rapid hemostatic resuscitation with blood to reverse hemorrhagic shock en route, then advanced airway only when necessary after transfusion. Outcomes from @NewOrleansEMS, @dcfireems , Grady EMS, @TidewaterEMS, Orange County (Fl), Palm Beach County Fire Rescue, BSO, and so many others tell the story. Importantly, the Faster Refill study from New Orleans showed an odds ratio of 0.2 for mortality among patients who got blood, a huge survival benefit. We conclude our letter by countering the Schoenfeld, et al claim that there is still equipoise on prehospital transfusion vs the old standard of care. Many details still need some good research, but we know now that early transfusion in the field saves lives @SPARC2024