A/Prof. Dan Martin1
1SAAS MedSTAR, Adelaide Airport, Australia, 2James Cook University, Townsville, Australia
Abstract:
Recently a young woman was driving in rural South Australia, where she collided into the rear of a stationary truck at high speed. Initial information had her as conscious, pinned by her pelvis, no radial pulse, and then rapidly reducing level of consciousness. Initial assessment and care were provided by local SA Ambulance Service resources, supplemented by a local Rural Emergency Response Network (RERN) Doctor.
A SAAS MedSTAR prehospital and retrieval team was tasked via fixed wing to the scene. On arrival approximately 2 hours post injury, the patient was found to be profoundly haemodynamically unstable, with confirmed abdominal free fluid, and bilateral fractured femurs.
Whilst inbound to Adelaide, the patient remained unstable despite ongoing in-flight resuscitation, including 2 units of red cells. The team requested the recently introduced Massive Transfusion Pack (MTP) be activated and waiting for them on arrival back at the RFDS hangar in Adelaide.
The MTP was added to the scalable suite of blood products available to SAAS MedSTAR. Its contents mirrors those of the MTP1 of the Royal Adelaide Hospital (RAH) Emergency Department – 4 red cell units, 3 fresh frozen plasma units and 1 pooled platelet unit.
The MTP is provide by the RAH Blood Bank, and can be collected by road, or by rotary wing asset. SAAS MedSTAR Coordination plays a critical role in both activating the MTP and providing logistic and coordination oversight for its collection.
On this occasion, the MTP was collected by a SAAS MedSTAR team not involved in the case, who met the incoming team with red cells attached to the fluid warming device, and fresh frozen plasma units ready to transfuse.
This case will be used as a platform to describe the MTP’s utilisation, transport considerations and most importantly how we use the MTP in the field today.
Biographies:
Dan is the Director of Nursing for SAAS MedSTAR Emergency Medical Retrieval. He began prehospital and retrieval career with RAH Mediflight, then joining SAAS MedSTAR as a founding member.
He is a RAAF Nursing Officer, and instructor for the Military Critical Care Aeromedical Evacuation Team course, with strategic aeromedical evacuation and exercise experience. He also holds an academic title with James Cook University, specifically the Post Graduate Certificate in Aeromedical Retrieval.
Dan is an AUSMAT Team Leader with deployments in response to sudden onset disasters and disease outbreaks, most recently in support of the Non-combatant Evacuation Operation out of Afghanistan.