An observational study of pre‐hospital central venous access for patients with haemorrhagic shock due to major trauma
Authors' conclusion
In patients with exsanguinating haemorrhage who are in severe shock or traumatic cardiac arrest, pre-hospital trauma line insertion is feasible and associated with an acceptable risk of procedural complications.
Study context
- Population
- Patients with exsanguinating haemorrhage due to major trauma attended by London's Air Ambulance, 2019–2023insertion attempted
- Participants
- 346 patients
- Exposure
- Successful vs unsuccessful pre-hospital trauma line insertion
- Successfuln = 276
- Outcome
- Feasibility, efficacy and safety of pre-hospital 14-Fr trauma line insertion
Main finding
As reported in the abstract
Trauma line insertion success
Successful insertion
276
80%
Observational data: associations, not effects.
Further findings
Pre-hospital blood products transfused
P < 0.001
Survival to ED presentation
P = 0.006
Safety
Complications among patients transported to hospital (n = 184)
- Any complication
- 8 (4%)
- Malpositioned trauma line
- 3
- Vascular injuries
- 2
- Iatrogenic pneumothorax
- 2
- Positive trauma line tip culture
- 1
Original publication
An observational study of pre‐hospital central venous access for patients with haemorrhagic shock due to major trauma. Anaesthesia. Published 14 September 2025. doi:10.
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