Whole blood delivered to trauma patients

CRAWFORDSVILLE, Ind. — Feb. 7 was a historic day for the Crawfordsville Fire Department.

When they picked up one unit of low-titer type O whole blood, they became the first rural agency in the Midwest to administer whole blood on a ground ambulance.

Through a partnership with Ascension St. Vincent Hospital in Indianapolis, Versiti Blood Center of Indiana, Indiana Department of Homeland Security and the Emergency Department of Franciscan Health, the fire department can save lives by providing whole blood transfusion in trauma situations.

“It’s very impactful,” said Paul Miller, deputy chief of the Crawfordsville Fire Department.

“It has a significant impact on the patient’s survivability. Typically, when you’re in a rural setting, your zip code dictates your outcome. There are usually fewer providers and less access to care.”

Miller shared his story with AgriNews.

Q: Tell me a little about Montgomery County.

A: We have about 16,000 residents here in the city, but we cover the entire county for EMS, which is about 38,000 to 39,000 total in our county. We cover pretty large square mileage — just over 500 square miles.

Q: How far away is it from rural areas of the county to a hospital?

A: We are well over an hour from most level-one trauma facilities from any point in our county. That was the big reason for trying to utilize whole blood as a proof-of-concept study. The trauma rule for the state of Indiana is to have patients to a level one facility within 45 minutes.

Typically we would have to call for an air ambulance, which is really expensive. Now we don’t always have to.

All of our firefighters are required to be paramedics. The tool gives us the time we need to get people to a trauma facility, hopefully even encouraging the clotting process with some of the medications we’re giving.

Q: What difference can whole blood provide to trauma patients?

A: Giving whole blood immediately, within the first 15 minutes of injury, can promote new clot formation in the body along with the medication we give to help the patient recover sooner, or at least get them to a point where we can transfer them to a trauma facility to allow the surgeons to work.

Q: Have you had to use whole blood on scene yet?

A: Yes. We have administered it recently at a shooting.

Q: Are you the first to provide whole blood?

A: Other agencies have been doing this for a while with component blood therapy, whether it’s packed red blood cells or plasma. They respond with a fellow, a doctor in training, to deliver it.

We and a county-based EMS agency were both granted the ability to do this on the same day.

We are the first fire department in the entire Midwest, and one of the handful nationally, that have looked to provide this level of care.