Air ambulances in
The technique involves using whole blood as it comes out of the donor’s arm, instead of separating out red blood cells, plasma and platelets.
Platelets aid clotting but are difficult to store, so they are not usually carried by air ambulances.
NHS Blood and Transplant (NHSBT) will trial the scheme following evidence from the battlefield in Afghanistan that it can cut time to treatment and boost survival chances.
Major trauma kills more than 5,400 people every year in the UK.
Dr Laura Green, a consultant in haemostasis and transfusion medicine at NHSBT, said: “Any delay to starting transfusion during traumatic blood loss can reduce the chances of survival.
“We hope [the trial] will show there are logistical and procedural benefits in giving a blood transfusion of all of the components in a single bag – and ultimately improved outcomes for patients.”
Once platelets have been filtered out of the blood they have a short five-day shelf life, must be stored between 20C and 24C, and need constant gentle movement to help them stay oxygenated.
This means they are only usually available once patients reach a hospital.
Carrying and transfusing only one blood product could also simplify the treatment process, sparing precious seconds.
The SWIFT whole blood study will involve 10 air ambulance charities across the country working in partnership with the Ministry of Defence and Air Ambulances UK.
Some 848 patients will be recruited over two years. Half will receive transfusions of red blood cells and plasma separately, with platelets given if needed after arrival at hospital.
The rest will receive whole blood. The trial will compare survival and the amount of blood needed over the first 24 hours after injury.
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All blood used will come from O negative donors – the universal blood type which is used in emergency care when there is not time to check a patient’s type.
The trial begins on Thursday with London’s Air Ambulance, before nine other services join as blood stocks stabilise following recent shortages.
If whole blood is found to be more effective, it could improve both civilian and military trauma care.
Professor Jason Smith, professor of emergency medicine for the Ministry of Defence, said: “We have known that blood transfusions save lives in patients with life-threatening haemorrhage for over 100 years, but the exact nature and optimal timing of those transfusions is still not known.
“This study will hopefully give us the answer as to whether whole blood is better than our current standard care in terms of clinical and cost effectiveness.”
Simmy Akhtar, Air Ambulances UK CEO, said: “Air ambulance crews are continually striving to provide the highest level of patient care and we hope the results will ultimately improve trauma care.”
Neil O’Brien, Minister for Primary Care and Public Health, said: “This vital trial could ultimately help save the lives of both patients at home and those defending us in conflicts abroad and shows what can be achieved when we all work together.
“I also want to take this opportunity to remind people of the importance of donating blood – more appointments are becoming available over Christmas and New Year and I urge existing donors to continue to book in.”
Generous blood and plasma donors saved my son, says mum
Ollie Berry, 19, was saved by blood and plasma after being hit by a van while riding his bike.
He suffered liver damage and lost around six units of blood after the collision in June 2019.
Ollie was treated by medics at the Great Western Air Ambulance Charity, who said that without a transfusion he would have died.
The teen was rushed to Southmead Major Trauma Unit in Bristol where he spent weeks in intensive care.
Ollie’s mum Rachel James, 47, of St Braivels, near Chepstow in Gloucestershire, said: “He was urgently given all the blood products they carried.
“Ollie has always been aware and that he is here today due to the blood and plasma provided by generous donors and the amazing team that worked on him. Every minute counted.
“I really hope the new trial will work and that more lives can continue to be saved through using whole blood transfusions.”
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