Bleeding Out: The Trauma We Can Actually Fix

Listen to this episode from The FlightBridgeED Podcast on Spotify. In this powerful and unfiltered episode, Eric Bauer sits down with Dr. Mark Piehl—pediatric ICU physician, trauma resuscitation expert, and inventor of the LifeFlow device—for a deep conversation that will reshape how you think about blood product administration in trauma care. From pediatric hemorrhagic shock to adult penetrating trauma, from urban EMS to rural ground teams, they unpack the most critical emerging concepts in early resuscitation.You’ll hear eye-opening real-world cases, challenges in implementation, and candid debates about whole blood, plasma vs. PRBCs, and whether saline still has a place. If you’ve ever questioned how fast, how early, or even if we should be administering blood products in the field—this episode is essential listening.Whether you're just getting into critical care or you're a seasoned physician or flight clinician, there’s something here that will challenge you, inspire you, and push your practice forward.🎧 Available anywhere you get your podcasts—or right now at flightbridgeed.com. While you're there, explore our award-winning critical care and certification prep courses trusted by over 30,000 providers worldwide.Contact Mark Piehl at [email protected] Takeaways:Early blood product administration in the field dramatically increases survival—especially in penetrating trauma.Whole blood may be ideal, but component therapy (plasma + PRBCs) is a powerful and proven alternative—even in urban EMS with short transport times.Traumatic arrest is not always the end. With witnessed arrest and early transfusion, survival is possible—even likely in the right cases.Shock index is an underused but powerful indicator for when to trigger blood administration, and its value applies to both adults and pediatrics.Volume matters, but so does composition: PRBCs deliver oxygen, plasma helps heal vessels—both are needed, and timing is everything.Saline isn’t dead—there are valid, lifesaving uses for crystalloids in certain TBI and pediatric cases when blood isn’t available.Implementing a blood program builds better clinical teams. It’s not just about saving lives—it sharpens every aspect of your trauma care.