Sachse Fire-Rescue is adding another component to its emergency medical services that could help provide better care and save lives.
Beginning Wednesday, Sept. 14, all ambulances used by the department will carry a cooler with blood products supplied by Carter BloodCare.
Deputy Fire Chief Lee Richardson said he spent two years working on logistics for the program, beginning in 2020. Part of his process included identifying the potential need for lifesaving transfusions and a supplier of the blood.
The latter was the most difficult, he added, because there is often a shortage of supply relative to demand for blood and blood products.
Between October 2020 and October 2021, Richardson said he identified 12 instances where blood could have been transfused to a patient inside a Sachse ambulance. Since he had a visit with Carter BloodCare a few weeks ago, he identified two instances where it could have been given to a patient.
Studies show that blood transfusions that happen sooner rather than later can actually reduce the overall usage of blood products, said Richardson. Part of that is the waiting time at a hospital where a patient could wait to get checked in and assessed prior to a transfusion.
“When you have a life-threatening hemorrhage, time is of the essence to get that bleeding stopped and replace what is being lost,” Richardson said. “By carrying these blood products, we can get them into the patient 40 to 45 minutes sooner than they would get at the hospital.”
When EMS personnel actively give the blood products to patients, he added, the patients’ bodies are able to respond more effectively because necessary clotting agents in the blood are being injected sooner.
Additionally, Sachse Fire-Rescue will be in a unique position being among a handful of departments carrying blood products on its ambulances. Nationally, there are around 30 agencies that carry blood products, said Richardson.
Among the 23 BEST EMS departments, which include Addison, McKinney and Carrollton fire departments, Sachse’s will be the only one to carry blood products, he added.
“It shows the department’s and city’s commitment to providing the highest possible level of pre-hospital care,” Richardson said. “Over the last two or three years that we have been with the BEST EMS program, we have been on the forefront in the system. This is another step to make sure that we’re providing everything we can to the community.”
Fire Chief Martin Wade echoed Richardson’s sentiments, saying the department routinely is among the best when it comes to EMS service.
“Emergency Medical Services (EMS) is the majority of what we do, and I believe we excel at it,” Wade said. “Our goal is to provide the best possible care to those we serve, and the new blood program is a prime example of how we continuously improve our services and accomplish this.”
Despite Carter BloodCare’s willingness to partner with Sachse Fire-Rescue, there were concerns about the consistent supply of blood given a nearly continuous shortage. As part of the agreement, the department will hold regular blood drives and pledged to commit three packs of blood or blood products for every one used.
Additionally, the new program is not as straightforward as carrying the blood and giving it to those in need, said Richardson.
Each ambulance will now have a special cooler space on board, he said, that will only house blood products. It also has a triple redundancy system to maintain the ideal storage temperature of between 1 and 6 degrees Celsius.
“The one big thing that has taken us this long is I do not want to waste blood,” Richardson said. “That is the number one reason why we have to be very diligent in our storage and transport.”
The blood products also have a certain shelf life, he added, so the department will try to transfer its allocation to trauma centers or other sources that will use it rather than let it go to waste.
“We want to be good stewards of the blood,” Richardson said. “I wasn’t willing to put a program together that was going to waste blood.”
In addition to transporting the blood for transfusion, ambulance crews will also have a machine used to warm blood. The machine will take the blood from the cold storage and warm it to slightly over 100 degrees before it goes into a patient.
“We can’t give that [the cold blood] to a person because it makes them hypothermic,” Richardson said. “Hypothermic patients bleed more, they don’t clot so we have to warm it up.”
Paramedics will also use a rapid infusion device that is capable of injecting 10 milliliters of fluid into a patient in a controlled manner, said Richardson. This will help EMS personnel know exactly how much blood has been transfused into a patient, adding that each blood product IV bag holds between 275 and 300 milliliters of fluid.
“We can infuse that entire blood product in three or four minutes with this device,” Richardson said.
To help with the implementation of the program, the fire department trained all personnel on the criteria for a transfusion. Beyond paramedics, it will enable all personnel to recognize when the procedure may be required.
This could lead to a potential expansion of mutual aid calls the department responds to, said Richardson.
The deputy chief added that he thinks this service may also gain traction with more rural departments that may have longer transportation times to hospitals.
“Training wise and cost wise, it’s not for everybody,” Richardson said. “It’s not for people with short transport times or for people whose paramedics are not in the upper echelon of their abilities. It’s not going to be on every ambulance in every city.”
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