En Route Blood Transfusions Save Lives, Require Simple Temperature Monitoring to Protect Blood Supply
More than 80 individuals have emerged as survivors of shooting incidents in Indianapolis this year alone, according to the Indianapolis Metropolitan Police Department.
Yet, one particular case stood out from the rest.
The patient was in critical condition, experiencing severe blood loss and shock, pushing the boundaries of survival.
Paramedic Bruce Tilson, who administered the transfusion, described the patient's dire state: conscious but with dangerously low blood pressure and signs of internal bleeding.
Despite having seen similar cases before, the paramedics realized that standard procedures would not suffice.
The quick thinking and skilled actions of the Indianapolis EMS team were crucial in stabilizing the patient, who had lost over a liter of blood and the time for survival was dwindling.
"We've done four transfusions,” Tilson said. “This was the first one to be successful."
The partnership between IEMS and Eskenazi Health, established in 2022, has been instrumental in equipping paramedics with the necessary training, tools, and blood supply for on-scene transfusions.
In this instance, a designated IEMS ambulance, equipped with a life-saving blood supply, played a pivotal role in this unprecedented rescue.
Paramedic Anthony Garcia shared the profound impact of being part of this historical moment for Indianapolis EMS.
The initiative utilizes military-grade technology for blood storage and warming, ensuring immediate readiness for transfusion, a practice praised by IEMS Medical Director Mark Liao for its adaptation from military to civilian medical use. The process requires temperature monitoring technology that can work remotely to ensure blood is stored at the appropriate temperature when it's needed.
This successful case underscores the critical need for blood donations.
Liao emphasized the life-saving potential of such contributions. The initiative not only showcases the potential for innovation in emergency medical services, but also highlights the community's role in supporting these life-saving efforts.
Liao reiterated the importance of these programs in revolutionizing emergency care, especially in communities distant from medical facilities.
The Pre-hospital Blood Transfusion Initiative Coalition highlights that blood loss is the foremost cause of preventable deaths among trauma victims.
This successful intervention by Indianapolis EMS is seen as a beacon for the expansion of field transfusion programs nationwide.
With the push to equip more EMS organizations with this life-saving capability, the hope is that survival rates across the country will see a significant increase.
This incident in Indianapolis serves as a harbinger of hope and innovation, demonstrating the life-saving potential of advanced medical practices and the power of community support through blood donation.
A prehospital blood transfusion is when medical personnel, such as paramedics or emergency medical technicians (EMTs), provide blood to a patient at the scene of an emergency rather than waiting until they reach a hospital.
According to a report in EMS World, a leading publication in the field, “exsanguination remains the leading cause of preventable deaths among trauma victims, with nearly half of these patients dying in the prehospital setting. And data shows for every one-minute delay in prehospital resuscitation there is a two percent increase in the odds of 30-day mortality.
In a recent position statement, the American College of Surgeons Committee on Trauma, the American College of Emergency Physicians, and the National Association of EMS Physicians said that all patients with exhibiting hemorrhagic shock should receive blood products whenever available.
Similary, the International Association of EMS Chiefs issued a statement in which it said:
“Pre-hospital paramedic blood transfusion programs are now critical to improving the immediate medical response to severe injury resulting in blood loss in America,” the IAEMSC said.
“Prehospital resuscitation with blood or plasma holds the potential to change the calculus for resuscitation in the field by EMS, given the fact that the “golden period” is often a decisive factor in patient survival. When major trauma results in severe blood loss, using crystalloid fluids like saline for initial resuscitation may be doing more harm than good.
“Modern blood product transfusion has been the standard of care therapy for replacing acute blood loss resulting in clinically-significant hypoperfusion for almost 100 years.”
Prehospital transfusions are important for a few reasons:
Expands treatment options: Not everywhere has readily available blood products in hospitals, so prehospital transfusion can be a critical stopgap measure.
It's important to note that prehospital transfusions aren't always a given.
Deciding who needs one requires careful assessment by medical professionals and isn't without risks. However, research and practice are evolving to make prehospital transfusions a more viable option in critical situations.
EMS providers looking to support a prehospital blood transfusion program should ask questions across several key areas:
Liability Concerns: Are there any legal or liability concerns associated with prehospital transfusions that need to be addressed?
Additionally:
By asking these questions, EMS providers can gain a comprehensive understanding of the prehospital blood transfusion program and how they can best support its implementation and success.