By Ben Conley
The Dominion Post
MORGANTOWN, W.Va. 鈥� It鈥檚 just a matter of time.
Barring other complications, a patient suffering a severe hemorrhage has about 30 minutes to either receive blood or arrive in an operating room before the likelihood of survival begins to plummet dramatically.
On average in the U.S., the time between a 911 call and an operating table is 74 to 88 minutes.
What happens in between can make all the difference.
On Monday, Monongalia EMS officially announced the May 1 launch of a new program through which whole blood will be available prehospitally as a lifesaving measure for patients in critical condition with significant blood loss due to traumatic injury or other medical reasons.
Mon EMS will be the third agency in West Virginia to offer the service, behind Cabell and Harrison counties. Nationally, less than 100 EMS or fire services utilize whole blood in pre-hospital care.
鈥淚 think where that鈥檚 especially important is our rural communities of the county, especially in the Blacksville area, eccetera. This is where this truly is going to matter most and will have the greatest impact on our patients because it already takes them 20-plus minutes to get to the hospital, " Mon EMS Director of Clinical Services Robby May said. 鈥淲e can get that blood on scene to them and into them at the time that they need prior to actually making it to WVU and into the operating room.鈥�
Mon EMS educators Ray Wolfe and Crist Mentzer demonstrated the process by which the necessary equipment is deployed and 500 ml of warmed blood can be administered to a patient within just a few minutes.
With the exception of trauma to a major artery, Wolfe said blood can typically be pumped into a patient faster than a body can lose it.
鈥淭he data behind whole blood is fantastic when it comes to trauma. Previously, we have been using crystalloid or normal saline to try to resuscitate patients when they鈥檙e losing too much blood. As you might imagine, giving salt water back to someone who鈥檚 losing blood does not give them the effective treatment they need, " Mon EMS Medical Director Dr. Michael Shukis said. 鈥淭hey need to have that repleted. We鈥檙e already there to stop the bleeding. We know how to do that part. Now we need to be able to fill the tank back up.鈥�
鈥淲hole blood " contains all blood components 鈥� red blood cells, plasma and platelets.
Low titer Type O + whole blood has been shown to be safe for patients of all ages and blood types, including children and pregnant women. It鈥檚 approved for transfusion to critically ill and injured patients whose blood type is unknown by the U.S. Food and Drug Administration as well as the Association for the Advancement of Blood & Biotherapies.
According to information provided by Mon EMS, the likelihood of a transfusion reaction is about one in 40,000 patients. For unresponsive patients, clinicians are trained to check for relevant medical identification and alert tags that could indicate a patient鈥檚 objection to receiving blood.
The blood, as well as the approximately $10,000 in man-portable equipment, will be carried by shift supervisors driving the Mon EMS SUVs. They can arrive on scene in addition to an ambulance for calls in which heavy blood loss is indicated.
Mon EMS will obtain whole blood for the program through a partnership with the WVU Blood Bank. To prevent waste, the blood will be exchanged weekly so it can go into circulation at the hospital and be used before it expires.
In addition to all of Mon EMS鈥檚 paramedics and AEMTs, paramedics with the Morgantown Fire Department have been trained to administer transfusions. All volunteer agencies affiliated with Mon EMS have been trained to recognize the need to get blood at the scene and assist with the process.
West Virginia is the first state in the country to provide statewide protocols for administering whole blood on ambulances.
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