Fayette County EMS Takes Step Toward Whole Blood Program

Fayette County EMS will test a program to provide whole blood for trauma patients.

EMS Director Josh Vandever spoke about the program at last Thursday’s Commissioners Court meeting. He was there to ask the court to sign an agreement with blood provider We Are Blood (formerly The Blood and Tissue Center of Central Texas).

Vandever said that rural EMS departments don’t normally carry whole blood on ambulances. Blood stays viable for only about 35 days after someone gives blood. It has to be stored at a very narrow range of temperatures, 0 to 4 degrees Fahrenheit, which requires specialized refrigeration equipment.

Currently, if a patient needs blood, EMS crews try to stabilize them with IV fluid – saline water.

“It drops your body temperature, for one, which hurts clotting,” Vandever said. “It dilutes the red blood cells and the oxygen-carrying capacity of what’s in your body.”

Up until now, it hasn’t been feasible for Fayette County EMS to provide whole blood.

“We are rural, we are far away from blood centers and suppliers, and we’re cognizant of our budget,” Vandever said. “We’ve been working through a process by which we could roll out a program like this and still be respectful of the taxpayers and also be respectful of the (blood) donors. We’re finally at a point where we feel like we’re not going to be wasting a whole lot of blood.”

Vandever said St. David’s South Austin Medical Center established a rotation program with the blood center.

“If blood starts to age-out on our trucks, we would be able to take it to South Austin, switch it with some blood that’s in the ER, and drive back to the County,” Vandever said.

He said Fayette County EMS received about $30,000 worth of equipment that can be used in the blood program through recent funding by the State Legislature.

Vandever said the first step in establishing a blood program will be to validate his department’s policies and procedures for handling blood. He said a refrigeration unit will be placed in an EMS supervisor’s vehicle. The unit will be equipped with technology to notify EMS personnel if the temperature begins to rise or fall out of the required range.

Vandever said the validation process will take several months to demonstrate that his department can reliably store bags of blood and exchange them before they expire.

“The big thing that’s being said right now is that your ZIP code shouldn’t dictate the level of care that’s available to you, especially out here,” Vandever said. “You get into a wreck on the interstate and nick an artery. You’re bleeding out. We can put a tourniquet on that, but we can’t replace that blood.”

Vandever said the contract with We Are Blood does not commit Fayette County to any additional expense.

“If this program isn’t going to work, we’re not going to do it,” he said. “We still have some things to work out. But signing this contract is the first stem.”

If the validation process is successful, and if the County wishes to pursue it, Vandever said Fayette County EMS could start administering blood to patients by the end of this year.