Life-saving plasma now on board air ambulance

GNAAS pilot Phil Lambert, John Quinn, of Blood Bikes Cumbria, Dr Rachel Hawes, Steve Rawlings, of Northumbria Blood Bikes, and GNAAS paramedic Andy Dalton.
GNAAS pilot Phil Lambert, John Quinn, of Blood Bikes Cumbria, Dr Rachel Hawes, Steve Rawlings, of Northumbria Blood Bikes, and GNAAS paramedic Andy Dalton.
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The Great North Air Ambulance Service (GNAAS) is now carrying another potentially life-saving product on board its aircraft.

The charity already carries red blood cells, enabling its specially-trained medics to give blood transfusions to patients with life-threatening bleeding either on board, or at the roadside.

This revolutionary approach recently celebrated its first anniversary in service when representatives from the organisations involved met patients who are alive today because of the rapid blood transfusions they were given at the scene of their accident.

GNAAS teamed up with Newcastle Hospitals and the blood bikes charities in Northumbria and Cumbria and the Henry Surtees Foundation to make that project possible.

Now the team has taken it one step further by carrying defrosted fresh frozen plasma on board its aircraft, which provides vital clotting components to help blood clots to form and to stop bleeding. It was used for the first time at the weekend for an incident in Cumbria.

GNAAS is one of the very first air ambulance charities in the UK to carry plasma on board, which when given together with the blood, is thought will offer patients an even better chance of survival.

Dr Rachel Hawes, consultant at Newcastle RVI and GNAAS aircrew doctor, who helped to get the scheme off the ground, said: "The transfusions we currently give are purely O negative red blood cells.

"It replaces lost blood and ensures that the oxygen carried by the new blood gets to all the major organs, buying us as much time as possible whilst we stabilise and transfer the patient to the nearest major trauma centre."

Dr Hawes – also an Army Reservist with 201 Field Hospital - added: "Blood on Board has allowed us to greatly improve outcomes for our trauma patients. Yet scientific studies suggest that up to 30 per cent of trauma patients with severe bleeding are no longer able to form blood clots normally by the time they arrive in the Emergency Department (ED), and in fact our own research confirms this to be the case in our region. This means that when the patients arrive in ED, they are in a condition known as coagulopathy – they haven’t been able to produce enough of their own blood clots to keep up with the bleeding and so the bleeding spirals out of control.

"By giving a more balanced transfusion, using equal volumes of red blood cells and plasma, we hope to prevent this happening to our critically ill patients, ultimately helping to save their lives.

“We are delighted to be in a position to provide the most up-to-date, clinical techniques."

A three-month trial began last week using the same cool boxes which were kindly donated by the Henry Surtees Foundation, which also provided blood warmers and two 4x4 vehicles to support the Blood Bikes with their transportation during poor weather.

The logistics will work exactly the same as in the Blood on Board project. Each day a member from both the Northumbria Blood Bikes and Blood Bikes Cumbria will collect a cool box from the RVI’s Blood Laboratories, transporting it to the two GNAAS airfields – Durham Tees Valley Airport and Langwathby, near Penrith.

Now the cool box will contain two units of blood and two units of plasma. The cool boxes keep their content cool for up to 48 hours and so if not used, they are returned to the RVI to be used during surgery and other procedures in the hospital.

Dr Hawes said: "To carry out a regional programme of this scale, across one of the most challenging geographical areas in the UK, takes great dedication and strong collaborative working. Blood, and now pre-hospital plasma on board the GNAAS aircraft, simply wouldn't be feasible without the strength of our partnerships and without the support of the public, whose donations make it all possible.”

Yvonne Scott, transfusion manager for the Newcastle Hospital'’ Blood Sciences Department, who has worked closely with Dr Hawes on the Blood and Plasma on Board schemes, said: "Blood transfusions are an essential feature in the NHS, used to treat many different types of illnesses and conditions as well as replacing severe blood loss due to major trauma.

"Blood is a mixture of red blood cells, white blood cells (which help the immune system fight off infection), platelets and plasma. For blood to function normally you need all of these components.

"After blood is donated it’s separated and split down into its different components which can be stored for longer. In most cases when we give blood or blood products in hospital the patient only needs one component. For example, if they are anaemic, they will receive just red cells. If they have a specific blood related disorders, they may just receive the platelets, and so on.

"However, if the patient is bleeding they are losing whole blood so we need to give the equivalent of whole blood back to the patient to keep them alive (which is a mixture of the above). Red blood cells carry oxygen round the body to the vital organs but plasma carries the clotting factors which are needed to make a blood clot and stop patients from bleeding.

"For major trauma patients, these are the two most important components in their time of need."