Austin Fleskes – Loveland Reporter-Herald, Colo
UCHealth and Thompson Valley EMS are taking a step forward in their goal of helping patients in critical situations by providing EMS supervisors with whole blood to conduct blood transfusions before a patient arrives at a hospital
“Hemorrhage can be life threatening, and we can (now) deliver blood in the field,” said Dave Edwards, a battalion chief with TVEMS.
The program is meant as a lifesaving measure that is being adopted by EMS agencies to deal with significant blood loss at an incident scene.
A whole blood transfusion involves the administration of blood that has not been separated into base components such as red blood cells, plasma and platelets, according to an information sheet provided by TVEMS; this method of is meant to deliver a “full spectrum of blood components that can better support critical trauma patients” who have experienced significant blood loss or internal bleeding.
Trauma stands as the fourth leading cause of mortality in the United States, with more than 30% of trauma-related deaths caused by “massive hemorrhage,” or serious bleeding, according to the fact sheet.
“Trauma is ubiquitous, it remains the leading cause of death from age 1 to 44,” said Dr. Chris Cribari, medical director for trauma and acute care surgery at Medical Center of the Rockies. “That fact alone should prompt people to recognize the importance of trauma centers and (that) pre-hospital trauma care equipped with things like tourniquets and whole blood are going to save lives.”
Both UCHealth EMS and TVEMS supervisors will have units of blood on hand should it be needed, all kept at a proper temperature for use at any time. All the blood that will be used is low titer O+ whole blood, a specific type of blood product that contains low levels of antibodies for safer transfusion and can be be given to patients universally, according to the TVEMS fact sheet.
When responding to an incident that requires a blood transfusion, supervisors can be called in or brought alongside responding crews. When they arrive on scene and care for a patient starts, that supervisor will then have the sole duty of providing blood to the patient in the ambulance on the way to the hospital; while the other paramedics address other problems, that supervisor will warm the blood up to the proper temperature for transfusion, hang it in a compression bag and pump the blood into the patient.
The blood will be coming from Garth Englund Blood Centers, which collect blood across various UCHealth locations in the area. Anna Johnson, the manager of the blood centers, said she sees the program as incredibly important and added that those who donate can make a real difference for others around them.
“This is anonymous blood donation for the betterment of our community,” she said. “It unites us … opposed to other things that might divide us.”
Medical professionals involved, from the EMS crews who will administer it to the doctors at the hospital, agree on one thing with the new program: it can save lives.
Simulated blood goes into a mannequin as Thompson Valley Emergency Medical Services personnel demonstrate how they will use whole blood to help patients with a critical blood loss before they arrive at the hospital. (Jenny Sparks/Loveland Reporter-Herald)
TVEMS Capt. Dave Souders said that, before this, paramedics could only provide saline to a patient, something that may have filled the gaps of lost blood but did not provide the vital life-saving components of a transfusion. He said this program is huge and will help people get back to 100% after an incident instead of just surviving.
“That is what this is going to do,” he said. “Give them that opportunity to be saved … where they can go back to a regular life.”
“Prior to this we (didn’t) have a way to replace what a patient is losing,” said Mark Betterton, EMS director at UCHealth. “Whether it is trauma or from child birth or any situation where they are actually losing blood … we have been able to give IV fluids, which expands a little volume but it doesn’t carry oxygen, it doesn’t replace clotting factors. For our patients it has been demonstrated … we can reduce morbidity and mortality secondary to hemorrhage.”
Dr. Jesse Johar, TVEMS medical director, said that many who have worked in medicine in some capacity have heard of the golden hour — the 60 minutes of time where a patient can be saved following a trauma incident. This hour, he said, is really more like 26 minutes to get in front of a trauma surgeon. This program, he said, gets needed blood to the patient at the right time to make sure they can get to a hospital and receive expanded care.
“If somebody is dying from blood loss, the treatment is to give them blood,” he said. “It is really about getting the tools to the patient.”
“Patients who receive whole blood within 15 minutes of injury, the likelihood of them walking out of the hospital skyrockets,” Edwards said.
Dr. Warren Dorlac, a trauma and critical care surgeon at MCR, said the sooner blood can be transfused into patients who have lost a large amount of blood the better when it comes to improving the chance of survival.
He added that much of the research into the importance of whole blood has come from the United States Military, saying “there have been a lot of American soldiers who have paid the price in blood” to educate the medical community.
“We have learned from those experiences,” he said. “The fact we can bring this back to our local communities and provide the same care we have learned from our combat lessons is a great message.”
Betterton added that this program, one that will help save lives for people in need, was a result of the teamwork and partnership across the region.
“It is remarkable in Northern Colorado that between UCHealth EMS and Thompson Valley EMS working with the Garth Englund Blood Centers we have the ability to get this out there,” he said. “We couldn’t do it alone, we can only do it by partnering within the health system to make this happen.”
- With Trauma Deaths On the Rise, EMS Is Developing Prehospital Blood Transfusion Programs to Improve Survival and Recovery Rates – JEMS: EMS, Emergency Medical Services
- American College of Surgeons Supports Prehospital Blood Programs
- Prehospital Blood Transfusion Initiative Coalition Being Formed
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