Regional West Trauma Team Moves to Whole Blood Transfusions for Trauma Patients

According to the National Institutes of Health (NIH), trauma is the fourth leading cause of mortality in the United States, with more than 30% of trauma-related deaths due to massive blood loss.  

As an essential part of trauma care, blood transfusions are often carried out at trauma sites. When needed, Regional West’s Air Link helicopter team has historically administered red blood cells to patients en route to the hospital. While this program has saved lives, much research has been done over the years showing the benefit of transfusing plasma and platelets as well. The solution was to transfuse whole blood (which includes red blood cells, platelets, and plasma) instead of only red blood cells.

Once the FDA determined that Type O whole blood was safe to use in trauma situations in the field, it granted approval for civilian medicine use just as it has been in military medicine for over a century. There has been a paradigm shift all over the country and now Type O whole blood is the state-of-the-art product to give to trauma patients before reaching the hospital.

Going forward, Regional West Medical Center will carry whole blood on air ambulances.  

Researchers have long known that Type O whole blood was safe and effective for treating extreme blood loss after injury for patients of any blood type because Type O whole blood has been used for over a century by the U.S. Military, dating back to World War I. Out of an abundance of caution, the US Food and Drug Administration (FDA) did not allow whole blood to be used for civilian care until very recently.

According to Randall Williams, MD, FASCP, a pathologist and Regional West Medical Center laboratory director, studies clearly point to the clinical and logistical advantages of using whole blood for trauma patients, with a growing body of evidence showing that this product is far superior to the red blood cell-only policy of the past.

“Nationwide, as well as at Regional West, this product is saving lives,” said Dr. Williams. “The only way you could replicate this product would be to give red blood cells, platelets, and plasma separately – three bags, three transfusions – and this is simply not feasible in a helicopter environment.” 

He added that the practice was an immediate success as a trauma patient’s life was saved with a whole blood transfusion just four hours after the product was introduced for use at Regional West. 

“Type O whole blood contains Type O red blood cells which are considered to be “universal donor cells” because they can be transfused safely to patients of any blood type (O, A, B, or AB). Fortunately, there is an abundance of Type O blood donors with approximately 45% of the population being Type O,” Dr. Williams said.

Trauma Medical Director Rommie Hughes, MD, FACS, RPVI, a surgeon with Regional West Physicians Clinic-Surgery, Vascular Diagnostics and director of Regional West’s Trauma Program, said the new process will potentially decrease both morbidity and mortality in trauma patients. As Nebraska’s only Level II Trauma Center west of Kearney, he said that while it’s not necessarily cost effective for Regional West, it’s the right thing to do.  

“We’ve been working toward this goal since the FDA gained approval,” he said, “While Regional West will be among the smallest hospitals in the US to offer this lifesaving practice, it’s going to save lives and lesson the amount of complications, time spent in the hospital, and blood products our trauma patients will have to receive. That’s the beauty of it.”

Whole blood is viable for two weeks, after which it can be separated into the three components and be available for another week. Dr. Hughes said that the new process is feasible, thanks to the number of blood donors in the area.

“Our community generously supports the blood bank, but we need more donors in order to have a steady supply of blood,” said Dr. Hughes. “We don’t want to have to call people in a crisis situation – we need to have a steady supply of donors all year.”

Dr. Williams and Dr. Hughes have worked closely together to bring state-of-the-art transfusion services to the panhandle. Both physicians said they are excited to be offering this product to the region.

“We’ve been working toward this for four years,” said Dr. Williams.

To support the whole blood program and other blood transfusion programs in the panhandle, please consider donating blood or platelets. It is estimated that only 5% of people who are eligible to donate blood actually do so. Blood donors need to be in good health, be at least 17 years old, and weigh more than 115 pounds. Walk-ins to donate whole blood or platelets are accepted, but appointments are preferred. Located at 4021 Avenue B in Scottsbluff, West Nebraska Blood Center at Regional West Medical Center is open Monday through Wednesday and Friday 8:30 a.m. to 3 p.m., and on Thursday from 10 a.m. to 4 p.m. To schedule an appointment or to learn more, call the center at 308-630-2477.

“Blood donors are special people,” said Dr. Williams. “They give a gift that can save another person’s life and they do this without compensation and without ever knowing who received their blood. How many opportunities does the average person have to save someone’s life? This is your chance.”