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LifeFlight’s blood transfusion practices affirmed by new study

Mar. 3, 2015, 5:03 PM

by Jerry Jones

Research soon to be published in the Journal of the American College of Surgeons (JACS) shows that airlifted trauma victims who receive blood transfusions in the helicopter before arriving at a trauma center have a higher chance of survival – a practice Vanderbilt LifeFlight has followed since 1994.

Vanderbilt LifeFlight is the only critical care air ambulance provider in the Middle Tennessee region to carry blood on all its five helicopters and an airplane, with more than 10 percent of the trauma patients it transports receiving blood infusions while inflight.

Through the JACS study, researchers at the University of Pittsburgh evaluated their air medical evacuation strategy. The study aimed to determine if pre-trauma center blood transfusions were associated with improved outcomes. Over a five-year period, 240 patients who received in-flight transfusions were evaluated in comparison with 480 who did not receive blood until they arrived at the hospital.

After matching patients for how badly they were injured at the scene, the people who received blood transfusions while they were on the helicopter were more likely to survive on the first day after being injured; were less likely to be in shock when they showed up at the hospital; and didn’t need as many blood transfusions at the hospital just because they got the first blood transfusion in the helicopter, the study found.

This is the first study that evaluated the use of transfused blood in civilian trauma victims air evacuated directly from the injury scene and compared them with air-evacuated trauma victims who did not receive transfused blood. It is the largest study to date of a civilian in-flight trauma resuscitation protocol that has been used by the military in Iraq and Afghanistan.

Alex Jahangir, M.D., medical director of the Vanderbilt Center for Trauma, Burn, and Emergency Surgery at Vanderbilt, said the use of blood in pre-hospital care is important in those patients who are hemorrhaging.

“The leading cause of death shorty after a traumatic injury is hemorrhage,” explained Jahangir. “The ability to quickly transport a patient to a trauma center, and provide these critically injured patients with blood, if needed, prior to reaching the trauma center greatly improves outcomes and survivability. LifeFlight’s ability to provide this advanced level of care to the most critically injured patients allows the best chance of recovery to the people of our community.”

Neither Jahangir nor Vanderbilt was involved in the study. The study appears as an “article in press” and will appear in a print edition of the journal this spring.

It can be challenging for any helicopter program to carry blood due to the logistics of storing blood away from the blood bank. The blood must be refrigerated; the helicopter base must have a freezer which is constantly monitored for temperature control. Helicopters must have coolers when on a mission to keep the blood at an appropriate temperature. Meeting these requirements involves close coordination with Vanderbilt’s blood bank.

“Our mission is to take Vanderbilt care to the patient at the scene or hospital. Providing blood on the helicopter is an important component of that ability,” said Jeremy Brywczynski, M.D., medical director for LifeFlight and assistant professor of Emergency Medicine at Vanderbilt. “LifeFlight crews undergo extensive training to be able to administer blood in the field and work under close medical direction. It’s the right thing to do for the patient and it’s saving lives.”

LifeFlight has been delivering state-of-the-art medical care as a community asset since 1984. It is the only non-profit air ambulance program in the region.

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