According to a new BBC article (see link below) London’s Air Ambulance, the aptly-named London-based air ambulance service, is making UK air medical history. They are becoming the first air ambulance service in the country to carry blood on board. Will others begin to follow suit?
Despite state-of-the-art technology and modern comforts and conveniences that make some air ambulances, more and more, high-altitude intensive care units, very few air ambulances in the world actually carry blood on board. Australia, with its unique geography, is one such place where civilian air ambulances also carry blood on-board.
A new efficient refrigeration unit utilized by the American and British military (who carry blood on their rescue helicopters) will allow the civilian air ambulance service to safely carry blood supplies. This will allow transfusions to take place on scene rather than after the patient is airlifted back to the hospital. London’s Air Ambulance believes hundreds of lives could be saved by this new development.
The blood that will be carried on-board the helicopter is type O-negative, which can be transfused safely into any patient that needs it.
The blood is kept in what’s been termed a “golden hour” box, a military-grade refrigeration unit that can keep four units of type O-negative blood at exactly 4 degrees Celsius for 72 hours. Blood that is not used during the transport can be safely returned to the hospital, meaning none of the nation’s precious supply of “emergency blood” is wasted.
With type O-negative blood being such a precious commodity, the air ambulance service naturally faced some obstacles when seeking permission to carry blood supplies on-board. They not only had to assure UK authorities that the blood could be kept safely in the on-board refrigeration units, but also that the supplies could be tracked and accounted for sufficiently outside of the hospital.
London’s Air Ambulance has the advantage of having a helipad on top of the Royal London Hospital, which gives them simpler access to and monitoring of blood supplies. According to the BBC article, their service carries doctors more often than other air medical services in the country (whose crews consist of more paramedics than doctors); other air ambulances would have had to seek permission from authorities for paramedics to conduct transfusions.
Kent and Essex air ambulances, two services that also carry doctors, are also now looking at holding their own supplies of blood, as well as blood-related supplies like platelets and plasma.
“I really believe that us carrying blood routinely is going to make a big difference to many of our patients,” Dr Anne Weaver, lead clinician with the service, told BBC News. “We attend about 90 patients a year who are bleeding to death when we get to them.”
But London’s Air Ambulance helicopter doesn’t fly at night. The solution? Blood will also be carried aboard the service’s rapid-response cars, a fleet that operates at night as well as in the daytime.
“About half of people with traumatic injuries who die, die from bleeding,” Zane Perkins, a trauma surgeon with the service, told the BBC. “Often stopping the bleeding can only be done in hospital, but one of the ways to buy yourself time is to replace the blood they’re losing. I think carrying blood is a great step forward.”
London’s Air Ambulance, like many other air ambulance services in the UK, is fueled by charity contributions. The emergency service treated over two thousand patients last year. Of these, there were well over 700 calls involving critical injuries sustained in road accidents, and nearly 600 calls involving patients who had been stabbed or shot.
The blood will be particularly useful for two major categories of calls. Firstly, it will obviously be useful saving lives of patients in the city, where violent crimes are more common. Secondly, it will be useful for longer air medical transports to rural areas of the country, when patients need emergency transfusions and time is of the essence.
London’s Mayor Boris Johnson praised the service, saying they have “an international reputation for pioneering medical procedures which have been adopted around the world.” He went on to say that “[London's Air Ambulance] provides a great service across the capital and being able to carry blood on board means the team will be able to save even more lives.”
Should other air ambulances follow suit? As someone involved with the air medical field, how would you feel about blood being transported on-board your air ambulance? Please address your thoughts, comments, concerns, and other correspondence to the comments section below, or leave us a comment on Facebook.
Original Article: http://www.bbc.co.uk/news/health-16928621