“ I Vont to suk yure BLOOD!”
And replace it with universal blood!
A recent development over the last couple of years, certainly in the UK, in pre hospital medicine on air ambulances is the potential to administer blood to a patient.
More services are now operating with doctors and many techniques and procedures have evolved over recent years, mainly because of lessons and procedures learned from military operations in both Iraq & Afghanistan.
Trauma was being dealt with with such intensity that it has spurred evolution in medicine and medical techniques & interventions, which has then filtered through to the NHS and the ambulance services.
Some of the first areas where this has filtered to is on the air ambulances, where they deal with a much higher number of traumatic incidents in all sorts of situations.
Being involved in a motorcycle accident is deemed to potentially cause traumatic injuries, that left unattended will pose a significant or absolute risk to life.
One of the countermeasures now being adopted across some units is to carry universal O Negative blood, whereas before they were only able to administer units of sodium chloride solution which would bolster the fluid volume and help to maintain blood pressure.
The problem with traumatic injuries and high blood loss, either internally or externally, is that when only replacing with fluid, there is marginal benefit to the patient apart from volume issues.
Hence why blood is the best solution to administer prehospitally as it replaces blood and provides oxygen and other gases transport to and from parts of the body, where it is needed most, as well as supporting the volume function.
Currently we have 4 deliveries of blood per week, which we keep in a sealed temperature controlled case for 48hrs. If we use the blood at accident scenes, then when we transport the patent to hospital, we then get re stocked from the hospital blood bank.
If we don’t use the blood within the 48hr period, then the blood is returned to the blood bank and is then returned into general circulation…pardon the pun!
Since starting to carry blood over 12 months ago, we have used it in many traumatic accident situations;
road accidents, industrial & agricultural accidents also.
As a unit we are already seeing the tremendous benefits that giving blood at scene can bring, however we are constantly gathering more data, for those
patients that have survived and are recovering from their injuries and when blood has been used.
Whenever I speak to anyone regarding the air ambulance, not only the unit I work on, but in general terms; I always describe it as an evolving service.
A service that is changing and reviewing its best practices, best clinical procedures and best aviation solutions to deliver a service at the roadside, whenever we respond to a major traumatic accident.
The implementation of blood is just one of many evolutions that I have witnessed over the years and I imagine there are many more to come!
So more and more we are now able to provide hospital emergency department level care in the pre hospital environment; at the road side…where you need it most!