Auckland HEMS prehospital blood transfusion – coming soon to a helicopter near you

Bloody hell.

Pretty much summarizes the severe traumas that define the essence of our trade.

And sometimes, the answer to critical bleeding is to give blood.

We are grateful to our colleagues at Sydney HEMS, who advise: “blood is provided to transfuse patients with life-threatening bleeding after meticulous attention to hemorrhage control.”

Auckland HEMS is poised to begin providing prehospital blood as part of our bundle of critical clinical interventions. We are fortunate to collaborate with the New Zealand Blood Service and with our local District Health Board to provide this service. http://www.nzblood.co.nz

Herein, please find our training video. We welcome your feedback.

Our draft Blood SOP is undergoing usability testing with our clinical teams. Once finalized, we will share this for FOAM.

This is an unsystematic review of the current literature. A few themes are emerging:

1. There is now evidence of survival benefit in the military and in the civilian literature.
2. Beyond packed red blood cells, services are also exploring the use of plasma, and of whole blood.
3. Pouring in blood is frivolous without meticulous hemorrhage control.
4. If we are to forge strong links in the chain of trauma survival, these critically ill patients must move quickly to definitive care. We are working with our local trauma centres to move seamlessly from out of hospital into ED, Resus, Operating Theatres and Critical Care. Please share your experiences with us.
Dr Chris Denny, Auckland HEMS Medical Director
(Auckland HEMS team members click HERE for access to the draft SOP)
.

References:

Pretrauma Center Red Blood Cell Transfusion Is Associated With Reduced Mortality and Coagulopathy in Severely Injured Patients With Blunt Trauma

Prehospital blood transfusion in the en route management of severe combat trauma: a matched cohort study

Initial UK experience of prehospital blood transfusion in combat casualties

The effects of prehospital plasma on patients with injury: a prehospital plasma resuscitation

The feasibility of civilian prehospital trauma teams carrying and administering packed red blood cells

Prehospital Transfusion of Plasma and Red Blood Cells in Trauma Patients

Emergency whole-blood use in the field: a simplified protocol for collection and transfusion

Blood Far Forward–a whole blood research and training program for austere environments

Australian Patient Blood Management Guidelines

.

…and for simulation purposes, here is a blunt force trauma scenario:

An unidentified surfer discovers the hazards of being caught inside at a notoriously shallow reefbreak during the biggest swell in two years..

One thought on “Auckland HEMS prehospital blood transfusion – coming soon to a helicopter near you

  1. “Whole blood is what they bleed, whole blood is what they need”

    Thanks for sharing, look forward to the SOP.

    Are any Australia & NZ services signing up with the HURTregistry.org – basically a big FOAMeed map of what haemostatic agents carried by which service. If nothing else, it
    is good PR.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s