A medical technique honed on the battlefields of Afghanistan comes to the North for the first time today after months of research by trauma experts.
‘Blood on Board’ a new service to carry blood on the Great North Air Ambulance Service (GNAAS) was devised by emergency specialists at GNAAS and the Newcastle Hospitals’ Major Trauma Centre, for the benefit of patients across the North-East, Cumbria and North Yorkshire.
Northumbria Blood Bikes and Cumbria Blood Bikes, also charities, have stepped forward to facilitate the service by delivering blood from the hospital to the air ambulance on a daily basis, 365 days a year.
This new collaboration will help trauma specialists working with GNAAS and the Blood Bike groups save even more lives, by delivering emergency O negative blood directly to the scene of life-threatening accidents.
Catastrophic blood loss due to serious injuries and accidents kills around 50 people in our region every year. The most common trauma injuries we see are road traffic accidents, falls from a great height and assaults. The quicker patients receive blood transfusions following their injury, the better their chance of survival. The “Blood on Board” collaboration means that for the first time, this life-saving treatment can commence where the patient is injured, whether on a road-side, on a hill-top or in a remote community, rather than having to wait until they arrive at the Emergency Department.
Dr Rachel Hawes, Consultant in Anaesthesia and Pre-Hospital Emergency Medicine at the Royal Victoria Infirmary (RVI) in Newcastle works as an emergency doctor with GNAAS, and has over 15 years experience as an Officer in the Territorial Army. Whilst deployed in Afghanistan she saw military helicopters deliver blood transfusion supplies directly to the scene of severely injured patients. She recognised the potential of applying this in the NHS and headed up the “Blood on Board” project in the North East and Cumbria alongside GNAAS, and Northumbria and Cumbria Blood Bikes.
Rachel explains: “Replacing major blood loss for critically injured patients as quickly as possible is vital. Emergency Doctors and Paramedics working with GNAAS are specially trained and extremely experienced at stabilising patients at the scene of an accident prior to transferring them to the nearest Major Trauma Centre. For trauma patients, this often then means an immediate blood transfusion which can be lifesaving.
“We already have processes in place at the RVI’s Emergency Department whereby paramedics call a dedicated “Code Red” hotline to alert the hospital trauma team of patients en-route, with a catastrophic bleed. The RVI Blood Sciences Transfusion staff then immediately prepare a major haemorrhage pack so that blood transfusion can commence as soon as the patient arrives. Since our “Code Red” hotline began in the summer of 2013 we have seen patients not normally expected to survive, make amazing recoveries.
“The ‘Blood on Board’ concept takes this approach one step further allowing patients to receive seamless high quality care from the time of injury in the prehospital environment right through to hospital care. Having blood on-board GNAAS helicopters, may make a huge difference to a gravely injured patient’s chances of survival.”
How “Blood on Board” works
For the service to work, blood needs to be delivered to the GNAAS helicopters every 24 hours, and kept cool whilst in transit. Yvonne Scott, Transfusion Manager at the RVI’s Blood Sciences Laboratories explored the various products available and eventually found suitable long-term cool boxes. The well-established “Code-Red” process meant that the transfusion staff were already experienced in producing an urgent blood pack when needed but for the blood on board project required a specialist cool box that could be delivered to the helicopter and stay cool for 48 hours.
To ensure transit of the blood cool pack to GNAAS quickly and safely, David Malone, the Trust’s Transport and Travel Advisor, contacted the charitable-funded motorcycle services of the region – Northumbria Blood Bikes and Cumbria Blood Bikes. After explaining the needs of the project, both Blood Bikes organisations volunteered their services. This will save GNAAS around £40,000 per year in delivery charges and their inclusion in the structured supply chain makes the project a realistic possibility.
The Blood Bike groups will deliver a cool box of blood to each GNAAS helicopter every 24 hours, every day of the year, even in inclement weather for which it will use its 4×4 vehicle assets. GNAAS operates from two airfields – Durham Tees Valley Airport, near Darlington, and Langwathby, near Penrith.
Rachel adds: “The blood bikers are vitally important to making this service work and without their help the delivery of the blood from the RVI lab to the GNAAS airbases every 24 hours would be prohibitively expensive, preventing making this life saving service a reality.”
Peter Robertson, Chair of Northumbria Blood Bikes speaking on behalf of both groups says: “Our volunteer bikers deliver essential blood and urgent medical supplies, out of hours, to hospitals across the North East of England and Cumbria. The Blood Bikes, with their slim profile and emergency warning lights, can slip through busy traffic reaching their destination rapidly. We are delighted to provide an essential element of this region-first collaboration, ensuring urgently needed blood is delivered as quickly as possible.”
Dr Dave Bramley, Medical Director at GNAAS: “Our helicopters are never more than 25 minutes away from the nearest Major Trauma Centre. Yet time is vital for patients with life-threatening bleeds and so having blood on board, delivered by our Blood Bike colleagues, will make a real difference to saving people’s lives. We are very proud to be able to set up this pioneering approach, together with ‘Blood Bikes’ and one of the largest Major Trauma Centres in the country.”
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