Dr Oscar Wigginton1, Dr Sue Johnson1,2, Dr Beth Jervis3, Dr Mardi Steere4, Dr Anil Joshi1,3, Dr Ian Ferguson1,5
1Aeromedical Retrieval Service, New South Wales Ambulance, Bankstown, Sydney, Australia, 2Auckland Rescue Helicopter Trust (ARHT), Auckland, Aotearoa-New Zealand, 3CareFlight Australia, Northmead, Sydney, Australia, 4Royal Flying Doctor Service, Adelaide, Australia, 5South West Clinical School, University of New South Wales, Sydney, Australia
Abstract:
Background
Blood transfusion is a potentially life-saving prehospital intervention but frequency and type of product delivery across Australia and New Zealand is unknown. This study aims to describe transfusion practice across different services in the two nations, as well as identifying potential barriers to the carriage of blood products.
Methodology
Pre-hospital and retrieval medicine services across Australia and Aotearoa-New Zealand were sent a standardised questionnaire regarding their base characteristics and their current transfusion practice. Bases that only performed inter-hospital transfers were excluded.
Results
63 bases were contacted, but 5 were excluded as conducting only interhospital missions (4) or search and rescue (1). Of the remaining 58, 42 responded (response rate 72.4%). 67% of respondents routinely carry pre-hospital blood products. The majority (78.5%) carried packed red blood cells (PRBC) only. 14.2% carried both PRBC and plasma. 1 service (3.5%) carried whole blood. The median number of units of blood product carried was 4 (IQR of 3-4). 2 bases (7.1%) carried fibrinogen concentrate. All services carried TXA & calcium. 734 patients received a blood transfusion in 2021 with trauma being the most common indication (552). Base characteristics varied significantly in staffing, vehicle platform and transfer times. The median transfer time from scene to hospital was 56 minutes (IQR of 40-91). Services that currently do not have access to pre-hospital blood products identified multiple different barriers to supplying pre-hospital blood.
Conclusion
The type and number of blood products carried by each service varies across Australia & Ao-NZ. Transfer times range significantly between services but are generally long in Australia & Ao-NZ. This may impact the generalisability of overseas research findings to this setting. Multiple barriers exist to the carriage of blood by all services, which has implications for service equity, and is an avenue for further research.
Biographies:
Biographies to come