ROADSIDE blood transfusions have helped to save 18 lives in the North-East and Cumbria since being introduced just over a year ago, according to those behind the service.
Air medics from the Great North Air Ambulance Service (GNAAS) have performed 60 blood transfusions since the Blood on Board project launched last year, with a third of those deemed to have been of critical importance to survival.
The project is a collaboration between the Newcastle Hospitals, GNAAS and volunteers from the Cumbria and Northumbria Blood Bikes and was devised by Dr Rachel Hawes, Consultant in Anaesthesia and Prehospital Emergency Medicine based at the RVI and GNAAS.
This Saturday (April 2), some of the patients who might well not have been here today without this service will meet clinical staff and volunteers from the organisations involved, to celebrate the phenomenal recoveries they have made.
The pioneering scheme was introduced in January last year, and allows GNAAS doctors to perform blood transfusions on patients at the scene of a life or limb threatening injury. Patients who may quite literally be bleeding to death when the emergency teams arrive on the scene.
Before ‘Blood on Board’ was introduced, patients would have to wait until they had been transferred to the nearest Major Trauma Centre for highly specialist treatment. When heading to the Royal Victoria Infirmary’s Great North Trauma and Emergency Centre, paramedics would call a dedicated ‘Code Red’ hotline at the RVI to alert the hospital trauma team of patients en-route with catastrophic bleeding injuries.
Blood on Board takes this approach one step further, with specially prepared blood packs available for the air ambulance crews to take directly to the scene of an accident. This means that blood transfusions can be given almost immediately.
Dr Rachel Hawes, a Consultant in Anaesthesia and Pre-Hospital Emergency Medicine at the RVI, who is also a doctor on the air ambulance, headed up the project in the North East and Cumbria. As an Officer in the Army Reserve for more than 16 years, Rachel used her experiences gained during military deployment in Afghanistan as the basis for the idea for the scheme and adapted this to a system suitable for the North East and Cumbria.
Dr Hawes said: “About half of people with traumatic injuries who die, die from bleeding. Previously, stopping the bleeding could only be done in hospital, but one of the ways to buy yourself time is to replace the blood they’re losing. Carrying blood on board is a great step forward.”
Of Saturday’s event Dr Hawes added: “Today is about celebrating how this initiative has made such a huge difference to so many people’s lives. It gives the patients and families the opportunity to meet the many people involved in their care – not just the doctors and paramedics, but those behind the scenes such as the laboratory staff who prepare the transfusions packs every single day on top of their already extremely busy workload. We really couldn’t do this without them all.
“We are also acutely aware that this isn’t just about those who were injured. For many this has been a life changing event for the families and others close to the patients too. It will have been an emotional journey for everyone involved, and we just hope it allows them to reflect and understand more about what went on during a time they probably don’t have much recollection of.”
Dr Hawes said her research showed that 18 people who received the transfusions may not have survived if the treatment had not been available. Many others have had their outcomes improved by having the intervention.
Teenager James Atkinson, from Wigton, Cumbria, was left fighting for his life after a road traffic collision at Sebergham Bridge, near Wigton. He said: “I wouldn’t be here if it wasn’t for Blood on Board.”
Neil Wilson, from Berwick-upon-Tweed, was cycling on his way home from work when he sustained catastrophic injuries after being hit by a car near Ford. He said: “The fact that GNAAS now carry blood is the difference between life and death.”
Dr Hawes paid tribute to all those involved for making the project possible. She added: “It took quite a bit of work to get it off the ground with so many people involved and we are particularly indebted to our colleagues at Blood Bikes, the Great North Air Ambulance Service, Kent, Surrey, Sussex Air Ambulance and also the Henry Surtees Foundation who made significant donations including the cool boxes, warmers to heat the blood to the right temperature before transfusing, and transport cars.”
Peter Robertson, Chair of Northumbria Blood Bikes said: “When Rachel Hawes first contacted us to ask whether we would be prepared to support the Blood on Board project, both Blood Bike groups had no hesitation in saying an immediate “yes”.
“The help we received from our colleagues in Kent who were already supporting their local air ambulance was invaluable and our volunteers who give their time so freely all know that they are making a difference by helping to save lives. We are proud to be helping to deliver this vital service and are looking forward to meeting some of those it has helped”.
So how does ‘Blood on Board’ work?
· For the service to work blood needs to be delivered to the GNAAS helicopters every 24 hours and kept cool.
· Yvonne Scott, Transfusion Manager at the RVI’s Blood Sciences Transfusion Laboratories, sourced suitable cool boxes which were kindly funded by the Henry Surtees Foundation.
· This blood is prepared and packed in two cool boxes every evening by the RVI’s Blood Sciences Transfusion staff – the experts responsible for preparing major haemorrhage packs ready for transfusions at the hospital.
· To ensure safe transit of the blood packs to the Great North Air Ambulance Service air bases, local voluntary charities – Northumbria Blood Bikes and Blood Bikes Cumbria – ensure rapid delivery of the blood packs every day, 365 days a year. This saves around £40,000 a year in delivery charges.
· The partnership with the Blood Bikes shows the huge team effort it takes to make this type of operation feasible on a region-wide scale. Volunteer blood bikers, hospital staff, pilots and doctors work together to ensure that the GNAAS can provide pre hospital care to people who require urgent attention.
· Since ‘Blood on Board’ started in January 2015, over 800 cool boxes have been transported by Northumbria Blood Bikes & Blood Bikes Cumbria to the two air ambulance airfields – Durham Tees Valley Airport, near Darlington, and Langwathby, near Penrith.
· The Blood Bike groups deliver the cool boxes of blood to each GNAAS helicopter every 24 hours, every day of the year, even in inclement weather when they use their 4×4 vehicles (also generously supplied by the Henry Surtess Foundation). Journeys of almost 300 miles per night, totalling over 100,000 miles a year!
· Since its inception a total of 60 transfusions have been given to 36 patients. Because the blood packs are held in the special cool boxes keeping the blood fresh for up to 48 hours, unused blood is returned to the Blood Sciences Laboratory at the RVI to be used during surgery and other procedures in the hospital. Emergency blood is a precious resource and we do rely on people giving blood to make sure we don’t ever run out of it.
· 75% of the patients treated were young males – the majority were involved in road traffic collisions (RTC)
· 25% of patients were females aged 55 years and over
· 83% of cases were high speed RTCs
· The remaining 17% were due to a range of injuries such as serious falls, incidents involving crushing and assaults
· 60% of cases were taken to the Major Trauma Centre at the RVI in Newcastle; 30% to James Cook University Hospital in Middlesbrough; and 10% to Royal Preston Hospital in Lancashire