{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:01:27Z","timestamp":1783051287406,"version":"3.54.6"},"reference-count":25,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies suggest that in children with hemorrhagic shock following injury, prehospital blood transfusion improves survival. Quantifying and understanding the current demand for blood transfusion will help us improve the use and availability of prehospital blood for pediatric patients. This study sought to describe the current demand for and utilization of prehospital blood resuscitation following motor vehicle crash (MVC) in pediatric trauma populations from 2020 to 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design and methods<\/jats:title>\n                    <jats:p>Hypotensive patients \u226414\u2009years after MVC included in the National Emergency Medical Services Information System (NEMSIS) from 2020 to 2023 were identified. Hemodynamic instability was based on age\u2010defined systolic blood pressure and heart rate parameters. Total number and percentage of children who received prehospital blood transfusion, including components or whole blood, were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The database included 391,764 children involved in an MVC. Of these, 1913\/391,764 (0.5%) were potentially eligible for prehospital blood transfusion based on prehospital hemodynamic status, yet of the 1913 patients, only 39\/1913 (2%) received prehospital blood. Eligible patients were generally older than 10\u2009years (64%) and MVCs occurred in urban areas (77%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Only 2% of hemodynamically unstable pediatric MVC patients received prehospital blood. Prehospital blood resuscitation is underutilized in pediatric MVC populations, suggesting an urgent need for focused evaluation to identify barriers and promote increased utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70114","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T07:14:27Z","timestamp":1770966867000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nationwide pediatric prehospital blood product use after motor vehicle crashes 2020\u20132023"],"prefix":"10.1111","volume":"66","author":[{"given":"Chandler A.","family":"Annesi","sequence":"first","affiliation":[{"name":"Center for Injury Science University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7426-8200","authenticated-orcid":false,"given":"Christine","family":"Carico","sequence":"additional","affiliation":[{"name":"Center for Injury Science University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Department of Surgery University of California San Francisco  San Francisco Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9489-3633","authenticated-orcid":false,"given":"Daniel T.","family":"Lammers","sequence":"additional","affiliation":[{"name":"Department of General Surgery The University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. Clay","family":"Mann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Utah School of Medicine, University of Utah  Salt Lake City Utah USA"},{"name":"National Emergency Medical Services Information System (NEMSIS) Technical Assistance Center (TAC)  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8144-3281","authenticated-orcid":false,"given":"Matthew J.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Department of Fire and Rescue Services Office of the Chief Medical Officer  Mariottsville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1731-3196","authenticated-orcid":false,"given":"Pawan","family":"Acharya","sequence":"additional","affiliation":[{"name":"Center for Injury Science University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Trauma and Acute Care Surgery, Surgery, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan O.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Center for Injury Science University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Trauma and Acute Care Surgery, Surgery, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Kerby","sequence":"additional","affiliation":[{"name":"Center for Injury Science University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Trauma and Acute Care Surgery, Surgery, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T.","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Pediatric Surgery Children's of Alabama  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8312-9157","authenticated-orcid":false,"given":"John B.","family":"Holcomb","sequence":"additional","affiliation":[{"name":"Center for Injury Science University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Trauma and Acute Care Surgery, Surgery, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zain G.","family":"Hashmi","sequence":"additional","affiliation":[{"name":"Center for Injury Science University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Trauma and Acute Care Surgery, Surgery, Department of Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Centers for Disease Control and Prevention NCfHS.National Vital Statistics System Mortality 2018\u20102023 on CDC WONDER Online Database released in 2024. Data are from the Multiple Cause of Death Files 2018\u20132023 as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed September 3 2025 http:\/\/wonder.cdc.gov\/ucd-icd10-expanded.html"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000003805"},{"key":"e_1_2_8_4_1","volume-title":"Analysis NsNCfSa","author":"National Highway Traffic Safety Administration","year":"2024"},{"key":"e_1_2_8_5_1","volume-title":"Motor vehicle occupant safety fact sheet","year":"2023"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000001425"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000004081"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamasurg.387"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1802345"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.18221"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16991"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0000000000002907"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2023.1291"},{"key":"e_1_2_8_15_1","volume-title":"Massive transfusion in children\u20102: a trial examining life threatening hemorrhage in children (MATIC\u20102)","author":"Spinella PC","year":"2025"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.21304\/2017.0401.00159"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000292"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15161"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2023.1297"},{"key":"e_1_2_8_20_1","unstructured":"Administration NHTS.National Emergency Medical Services Information System (NEMSIS). 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