BLOOD TRANSFUSIONS CAN now be delivered to patients in Dublin and Wicklow who are suffering from life-threatening bleeding – the first time patients in Ireland will be able to receive transfusions prior to arriving at hospital.

Haemorrhaging is one of the top causes of death following a major trauma, and the new service is expected to reduce mortality rates.

The blood transfusion laboratory at St Vincent’s University Hospital (SVUH) in Dublin, in partnership with Wicklow Rapid Response (WWRR), is now able to provide emergency blood and plasma at the scene of a trauma.

WWRR is a prehospital critical care service voluntarily run by Dr David Menzies, an emergency medicine consultant from SVUH, in partnership with the National Ambulance Service (NAS).

It is one of a handful of services in Ireland where doctors are tasked by the NAS to attend serious medical emergencies where the patient may benefit from critical care treatment at the roadside.

To date the only method for prehospital medics to resuscitate bleeding patients has been to use saline solution but, because it doesn’t carry oxygen or clot, it is not the ideal treatment.

From now on, the WWRR critical care doctor will be able to deliver life-saving blood transfusions to patients without having to wait until their arrival at an emergency department.

Speaking about the development, Menzies said prehospital blood transfusion “will reduce significantly the time it takes to deliver” treatment.

“There are a group of patients who are so severely injured that we will have blood waiting for them on arrival in the emergency department for immediate transfusion…

“Our current caseload indicates that a small but important number of patients may benefit from this every year.”

Menzies noted that such a facility “is already the standard of care for prehospital critical care services in the UK, Northern Europe, Australasia and the USA”, adding: “It’s fantastic that we can now offer it here in Ireland for the first time.”

No blood wastage

Dr Joan Fitzgerald, consultant haematologist at SVUH, said the development “will make a real difference to the treatment we can deliver to seriously injured patients in the region”.

“The medical scientists in the blood transfusion laboratory have worked closely with the emergency department, the National Ambulance Service and Wicklow Rapid Response to ensure the system is safe and secure with no wastage of blood products and full traceability 24/7 including holiday periods,” Fitzgerald added. 

In addition to red cells, WWRR will carry two units of plasma to promote blood clotting. While the red cells carry oxygen, transfusing plasma in a 1:1 ratio with red cells is the current best evidence for promoting blood clotting, a recognised problem in major trauma patients.

The emergency blood and plasma are supplied every 48 hours from the blood transfusion laboratory at SVUH and replenished as required. If unused, the products are returned within 48 hours to SVUH for use elsewhere, preventing any wastage.