Transfusions during transport
STARS air ambulance now carrying blood on board
BY SUSIE STRACHAN
Winnipeg Health Region
Published Tuesday, June 21, 2016
Trauma patients will no longer have to wait until they are transported to hospital for a life-saving blood transfusion, thanks to a “blood on board” initiative of the Shock Trauma Air Rescue Service (STARS) air ambulance.
By carrying blood products on board the helicopter, STARS crews will be able to make a difference between life and death for a number of their patients.
“For the critically injured, blood can make the difference between life and death. Bringing blood transfusion to the patient at the roadside is a game-changing treatment that very few other services in North America provide,” said Dr. Doug Martin, transport physician and medical director for STARS in Manitoba.
Kelvin Goertzen, Minister of Health, Seniors and Active Living with the province, visited the STARS Winnipeg base today to praise the service. “A prompt response can mean the difference between life and death for STARS patients,” said Goertzen. “Having blood on board will improve outcomes and help save lives.”
Cohen Hildebrand and his mother Megan were at the event to support STARS. Earlier this year, ten-year-old Cohen needed blood transfusions during transport from Morden to Children’s Hospital in Winnipeg.
“Cohen had tonsil and adenoid surgery in February, and he was recovering at home, when all of a sudden, he started bleeding from his throat,” said Megan. “His father rushed him to the hospital, where things got worse: an artery ruptured in the back of his throat. Cohen was losing blood faster than they could put it into him. Once they got him stabilized, STARS whisked him off to Winnipeg.”
STARS’ Winnipeg base is now one of six in Western Canada to offer this service. It is anticipated that STARS in Manitoba will use 30 units of blood per year, with a typical critical patient consuming two units during a transport.
“Access to blood in-transit will give the STARS flight-team one more tool to use when they respond to scene calls and during patient transport,” said Dr. Rob Grierson, chief medical officer, Winnipeg Regional Health Authority Emergency Response and Patient Transport. “Being able to provide this service to Manitobans is another example of the strong partnership we have with STARS, Diagnostic Services Manitoba and Canadian Blood Services.”
Flight nurse Jennifer Fosty with the “Bethune box”.
Two units of O-negative blood are stored on the STARS helicopter in an insulated “Bethune box” thermal cooler. The cooler maintains a temperature of four degrees Celsius with a monitoring device. If the blood is not used within 72 hours, it is cycled back to Diagnostic Services Manitoba, where it will be inspected and made available to other patients. The shelf-life for whole blood is 42 days when stored properly.
The blood storage cooler was named the ‘Bethune Box’ in honour of Dr. Norman Bethune (1890 to 1939), a Canadian surgeon who developed the first mobile blood collection and distribution service. Operating during the Spanish Civil War, Dr. Bethune’s service provided over 5,000 units of blood directly to severely injured patients along a 1,000 km battlefront, saving an estimated 300 to 400 lives. His innovation helped to shape contemporary approaches to the resuscitation and care of critically injured.
Flight nurse and clinical educator Jennifer Fosty said STARS crews have done transfusions a few times since mid-January of this year. “We’re heading into trauma season right now, with more road accidents,” she said at the event. “Being able to do transfusions during the flights means we’ll be treating the patient en-route, rather than having to stop off to pick up blood or wait until we get them to hospital.”