Trial of pre-hospital blood transfusions approved

Three month trial of pre-hospital blood transfusions approved

In a move that is a first for New Zealand, Auckland’s Helicopter Emergency Medical Service (HEMS) and its land-based Rapid Response Vehicle will be able to administer a pre-hospital blood transfusion at the site of an accident, medical emergency or in transit to the hospital, during a three-month trial that began on 12th December 2014.

The joint venture between New Zealand Blood Service (NZBS), Auckland Rescue Helicopter Trust (ARHT), Auckland District Health Board (Auckland DHB) and St John, will allow Auckland’s HEMS Critical Care Doctor-Paramedic Team to administer a pre-hospital blood transfusion during the critical time period directly after a serious accident or medical emergency, before the patient reaches hospital.

“This is the first time this service will be available in New Zealand as part of a bundle of critical clinical interventions. There is evidence from other countries such as Australia, the United States and the United Kingdom, where this is a standard practice, to support the use of pre-hospital blood transfusions,” said Christopher Denny, HEMS Medical Doctor for Auckland Rescue Helicopter Trust.

“The first hour following a traumatic injury or medical emergency is critical. All research points to improved survival rates for critically injured patients that receive a pre-hospital transfusion.”
Patients that receive a pre-hospital blood transfusion by the ARHT will soon be identified prior to arrival at receiving hospitals as ‘Code Crimson’, with trauma teams standing by to receive them on arrival. This will strengthen the ‘chain of survival’ for critically injured patients.

Auckland HEMS will carry one unit of O negative whole blood (containing red cells and plasma) as part of its standard practice during the trial period. Type O negative is referred to as the ‘universal blood type’ because in an emergency it can be safely transfused to anyone, regardless of blood type.

Asuka Burge, National Manager Marketing and Communications, NZBS said, “We have been working very closely with all the partners involved to ensure the whole blood is able to be transported safely both on the ground and in air.”

“The unit of whole blood will be transported in a Credo Blood Cooler, which is a military-grade lightweight portable device, much like a mini cooler box. The panels of the cooler box will be frozen at NZBS, and once fitted, ensures the product stays at a constant temperature of 4 degrees for greater than 72 hours.

“To decrease the risk of blood product wastage and to ensure blood is available when patients require it, the whole blood unit will be exchanged every two to three days with the NZBS Blood Bank based at the Auckland City Hospital (Auckland DHB)”.

The ARHT serves every community in the greater Auckland region, which is a total of more than 1.4 million people. Coverage is from Auckland, as far north as Te Hana, and as far south as Meremere, including Coromandel and the Gulf Islands. It undertakes approximately 1000 missions every year, and it is estimated the Auckland HEMS team will transfuse whole blood once a week.

The three month trial is scheduled to be reviewed in March 2015; “Pre-hospital blood transfusion is the standard of care for Pre-hospital and Retrieval Medicine services in Australia. We hope to demonstrate a similar benefit to patients here in New Zealand,” concludes Dr Denny.

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