Last week, I carried a new “drug” for the first time. Not Torodol or Acetaminophen which were recently added to our med kits as an alternative to opioids, but whole blood.
That’s right — whole blood.
My service (American Medical Response of Hartford under the medical control of Saint Francis Medical Center) is the first ground EMS service in New England to carry whole blood. Currently it is only being carried by our fly car medics (my Friday shift) and the evening and night supervisors. We carry a 500 ml bag in a cooler that is monitored for temperature around the clock. The bags are visually examined at the end of every shift and the temperature can be accessed at any time over an internet application.
The protocol calls for blood for hemorrhagic shock including trauma, GI bleed, AAA, and postpartum hemorrhage. Patients should have a BP less than 90 or a heart rate over 120.
To administer, we spike the bag with a line which has special heating coils in it, then we attach the line to a battery, which within 25 seconds heats the blood to body temperature.
The blood should only be given after stopping the bleeding with tourniquets, compression dressing etc. where applicable.
We carry 0 negative blood so the risk of a transfusion reaction is extremely small.
I did a couple heroin overdoses, a chest pain, a nausea and diarrhea, and a couple other calls, but no need for the blood.
In a future post, I will summarize the whole blood literature, which is quite compelling for prehospital use.