The life-saving use of blood and blood products pioneered by a Welsh mobile critical care service was the topic of discussion at a recent conference.
Dr David Rawlinson, Clinical Informatics Manager for the Emergency Medical Retrieval and Transfer Service (EMRTS Cymru), took to the stage at the British Blood Transfusion Society (BBTS) Annual Conference in Harrogate last week (22/09/16).
Launched in April 2015, EMRTS Cymru, also known as the Welsh Flying Medics, joined the Wales Air Ambulance (WAA) Charity helicopters to provide pioneering emergency medical care across Wales. The Service, which effectively takes the emergency room to the patient, is made up of Welsh Government-funded NHS consultants and critical care practitioners who are able to deliver innovative emergency treatments previously not available outside of a hospital environment. This includes using blood and blood products at the scene of an incident, known as Operation Vampire.
BBTS Conference delegates were told how EMRTS Cymru has become one of the first mobile emergency teams in Europe to have four types of blood and products available at the scene of an emergency. The helicopters and emergency vehicles now carry the following items that help to stop bleeding and replenish lost blood.
• Red Blood Cells: A fundamental part of the human circulatory system, red blood cells transport oxygen essential organs. Wales Air Ambulance carries O negative blood, which is compatible with all other blood groups, on missions.
• Lyoplas: A freeze-dried derivative of plasma, a liquid component that makes up approximately 50 per cent of blood. When mixed with water, it can be used to help aid blood transfusions at the scene of an emergency.
• Fibrinogen Concentrate: A concentrated dose of fibrinogen, which helps aid the blood clotting process. As with Lyoplas and the red blood cells, the Fibrinogen Concentrate is extracted from blood donated by members of the public.
• Prothrombin Complex Concentrates (PPC): This consists of components that assist the blood to form a clot. PCC is particularly useful for patients with life-threatening bleeding who are on anticoagulants (blood-thinning medication), such as warfarin.
The blood is supplied by the Welsh Blood Service via Blood Banks at Morriston Hospital in Swansea and Wrexham Maelor Hospital. The blood and blood products are delivered in a ‘Credo Golden Hour Box’ – a military-standard cooling bag which keeps the blood at a constant temperature of four degrees centigrade. These stocks are replenished every three days for the South Wales operation and every two days for the mid-Wales team. Unused blood is returned to the Blood Bank and is still able to be used in an emergency situation.
In the first twelve months of EMRTS Cymru operations blood was given to 47 people.
Dr Rawlinson said: “The pioneering use of blood and blood products by EMRTS Cymru in a civilian setting owes a lot to the armed forces. During conflict, military medics required a unique response to traumatic injuries and explored the use of these different types of blood products. Using the experience gained in this setting we have been able to learn from best practice and introduce this into our service. We were the first pre-hospital service in the UK to routinely carry such a wide range of blood products.
“Our thanks must go to the Welsh Blood Service, and everybody in Wales who gives blood.”
1. EMRTS Cymru is a partnership between the Wales Air Ambulance Charity, NHS Wales and the Welsh Government. The consultants and critical care practitioners fly on board the Wales Air Ambulance Charity helicopters which are based in Dafen and Welshpool. It is the generosity of the Welsh public, through donations to the Wales Air Ambulance Charity, which keeps the helicopters flying.
When the helicopters are unable to fly due to poor weather conditions, the service has access to a fleet of Rapid Response Vehicles.
To find out more about the Wales Air Ambulance Charity visit www.walesairambulance.com.
2. The Welsh Blood Service covers the whole of Wales. They collect voluntary, non-remunerated blood donations from the general public.
These donations are processed and tested before distribution to hospitals where they support patient care. The Service also holds blood-derived products (both NHS and Commercial) for purchase by hospitals. For more information visit www.welsh-blood.org.uk.
3. For further details please contact Steven Stokes, EMRTS Cymru Communications Manager, on 07866 796985 or via firstname.lastname@example.org.
Welsh Flying Medics Reveal Innovative Use of Blood
Monday 3 October 2016