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P114: Blood on board: the development of a prehospital blood transfusion program in a Canadian helicopter emergency medical service

Published online by Cambridge University Press:  11 May 2018

Z. Piggot ,
C. Krook ,
D. O’Dochartaigh ,
G. vanWerkhoven ,
J. Armstrong ,
S. Painter ,
R. Deedo ,
D. McKay ,
D. Nesdoly  and
D. Martin
Z. Piggot*
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
C. Krook
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
D. O’Dochartaigh
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
G. vanWerkhoven
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
J. Armstrong
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
S. Painter
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
R. Deedo
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
D. McKay
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
D. Nesdoly
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
D. Martin
Affiliation:
Shock Trauma Air Rescue Service, University of Manitoba Department of Emergency Medicine, Winnipeg, MB
*
*Corresponding author

Abstract

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Introduction: Prehospital blood transfusion has been adopted by many civilian helicopter emergency medical service (HEMS) agencies and early outcomes are positive. Shock Trauma Air Rescue Service (STARS) operates six bases in Western Canada and in 2013 implemented a prehospital transfusion program. We describe the processes and standard work ensuring safe storage, administration, and stewardship of this precious resource. Our aim was to produce a sustainable and safe blood storage system that could be carried on each mission flown. Methods: Close collaboration with transfusion services and adherence to Canadian Transfusion Standards was key at each step of development. An inexpensive, reusable, temperature controlled thermal packaging device was obtained along with an electronic temperature logger. Conditioning of the device and temperature maintenance (1 6C) was tested to ensure safe storage conditions. Online training programs were developed for air medical crew (AMC) as well as transport physicians (TPs) regarding administration indications, safety, and stewardship processes. Blood traceability and usage was monitored on an ongoing basis for quality assurance. Results: Two units of O negative packed red blood cells (pRBCs) are now carried on each flight. The blood box is conditioned and prepared by transfusion services for routine exchange every 72 hours. If pRBCs are administered the blood bank is immediately notified for preparation of another cooler. Unused blood is returned to blood bank circulation. Conclusion: The introduction of the STARS blood on board program supports the provision of emergent transfusion to selected patients in the pre-hospital environment. Our standard work and stewardship processes minimize wastage of blood products while keeping it readily available for critically ill and injured patients. Subsequent work will aim to describe characteristics and patient centred outcomes.

Keywords

quality improvement and patient safetyprehospital blood transfusionhelicopter emergency medical service
Type
Poster Presentations
Information
Canadian Journal of Emergency Medicine , Volume 20 , Supplement S1 , May 2018 , pp. S97
Copyright
Copyright © Canadian Association of Emergency Physicians 2018