Richmond ambulances to carry plasma – a first for the nation

RICHMOND, Va. (WTVR) –Richmond is one of three cities to be a part of a revolutionary medical trial that could save lives and change the way ambulance and combat medics hustle to rescue trauma patients.

“We are going to be one of three cities to administer freshly-thawed plasma to patients in the field,” explained Rob Lawrence, Chief Operating Officer of Richmond Ambulance Authority. “This is something not done in the US outside of the hospital.”

As most TV and movie watchers know, ambulance medics have long started IV lines for saline solutions. But not any actual blood.

This is critical because the platelets in blood – or blood products like plasma – slows bleeding, along with other benefits.

Dr. Joseph Ornato, the Chairman of Emergency Medicine at Virginia Commonwealth University and the Operational Medical Director of RAA, said this is crucial because serious bleeding and head trauma are the two big risk factors in serious accidents and injuries, affecting “tens of thousands of Americans every year . . . and this project is really targeted at the bleeding-to-death component of the problem.”

This extensive trial, funded by the Department of Defense, will be in Richmond, Pittsburgh and Denver, cities known for top-notch EMS and trauma systems, as well as strong partnerships with local hospitals.

So why hasn’t this been done before? The simple explanation is blood products are always in limited supply and only last so long once thawed. This system will put the plasma in refrigerators in  supervisors’ ambulances.

Once it’s out for X amount of time, it’s brought in and used at the  hospital, where it is always in demand. The hospital can stock the ambulances from their freezers. There is also new technology in dehydrating plasma until it’s ready for use.

Ornato said this general idea is borrowed from field medicine during WWII, when “transfusions were given from other soldiers who weren’t injured.” With the onset of blood banks about 60 years ago, the practice faded into the past.

“More recently, we’re discovering maybe that initial approach may have actually had some merit,” he said.

With RAA’s record of fast response times – at your emergency in an average of about 8 minutes from the moment of the 911 call, and often much faster – means lifesaving blood can be piped into your systems quickly, well before you’d get it at the hospital.

For more information about this program, go to http://www.cctr.vcu.edu/pdfs2/plasma%20study%20flier.pdf

7 comments

  • Bobby R.

    This is an exciting research study to follow. As a retired USN Hospital Corpsman(HM) I have witnessed severe trauma in a hostile fire theatre(combat) setting. If the data supports the hypothesis(as I think it will) this will advance pre-hospital care a quantum leap and drastically improve the outcome(favorable) of severe bleeding patients as well as improve the survival of now fatal hemorrhagic combat injuries.//HMC(FMF),USN-ret

  • Alan W. Rose

    Several failed studies of plasma substitutes. I guess like Coke, we are finally getting the “real thing.” But I’m a Paramedic in a rural agency, doubt we will get this anytime soon.

  • Jared

    Hasn’t this been done on air medical helicopters for more than 20 years? I know of a several programs in the Carolinas and South East who carry both packed red cells as well as plasma if my memory serves me correctly. My guess is that it will be either overutilized where a statistical insignificant difference is noted or it will be under utilized to the point of no longer being cost effective for the costs involved in running the study.

  • mandi

    Jared, it’ll be carried on your normal ambulance. Well, starting out with the supervisor SUV. My question is how does this affect things ethically for the patients who may or may not have religious convictions that do not allow blood and bi-products to be given to them. As a medic, I don’t get into asking patient’s religious affiliations…and in situations the plasma will be used, I don’t think time or the patient’s condition will allow for this to happen. What type of protocol will be used?

    • PartTimeGuy

      In situations where you would meet the inclusion criteria for the study, chances are that no one is going to have time to go through your wallet.

      If you are a knucklehead and would rather die than have plasma administered, you can opt-out by requesting and wearing a special bracelet that notifies EMS of your wishes.

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