Establishing Prehospital Transfusion with Airlift Northwest and Harborview Medical Center
Louzon, Max J
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Harborview Medical Center (HMC) routinely received patients transferred from outside facilities. These patients would be supported with blood products sent by the transferring facility, and on arrival these products would be discarded due to unvalidated shipping methods. This process put a strain on local blood suppliers and small transfusion services. The local aero-medical evacuation provider, Airlift Northwest (ALNW), also had no blood products to support trauma patients being transferred from the scene of the injury. These patients only began receiving transfusion support upon arrival at HMC. HMC partnered with ALNW to begin supplying blood products to support the transfer of patients. This process would entail validating a system to ensure the blood products would be kept at a storage temperature between 1-6℃. Since ALNW had six air bases throughout Washington and Alaska, the Credo Series 4 EMT cooler was validated to store the blood products for up to seven days to minimize transport between HMC and ALNW. To ensure an appropriate temperature was maintained in the cooler, a temperature recorder was placed in the cooler along with the blood products. HMC also used new blood products, low titer plasma and liquid plasma, to support prehospital transfusion. Low titer plasma (LTP) was defined as blood type A plasma with a titer of anti-B as ≤1:200. LTP was occasionally used in place of the traditional universal type AB plasma due to inventory control purposes. Typically HMC stocks thawed plasma that expires five days after thawing. To support ALNW holding blood products for seven days, liquid plasma was used as it expires 26 days after donation. All staff at HMC and ALNW were trained in handling the coolers as well as the applicable usage procedures. HMC began supplying blood products to ALNW in June 2015 and since then 24 patients have been transfused. Originally Boeing Field was the only site supported by HMC allowing for quick resolution of the problems encountered with the coolers, temperature recorders, and blood products. Since June 2015, the program has expanded to Olympia with plans to support the other air bases. The program for prehospital transfusion has also gained the interest of the organ transplant team and a separate validation will be taking place.
- Laboratory medicine