By Julie Anderson
Omaha World-Herald
OMAHA, Neb. — Once someone who is seriously injured in a car accident or a shooting begins to hemorrhage, a clock starts ticking.
Lose too much blood and the heart will stop because there’s nothing to pump. That also means there’s no blood to carry oxygen to the brain and other organs. Emergency responders can apply tourniquets to limbs to slow blood loss, but they can’t stop serious internal bleeding.
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But now Omaha firefighters have a way to stop the clock and begin putting blood back in the body, said U.S. Air Force Lt. Col. Reynold Henry, a trauma surgeon with Nebraska Medicine.
At the end of June, the Omaha Fire Department launched Nebraska’s first ground-based, prehospital blood transfusion program in partnership with the health system and the Nebraska Community Blood Bank.
Four medic units, one in each quadrant of the city, now carry whole blood that specially trained paramedics can give patients before they reach an emergency room.
Previously, Omaha Mayor John Ewing said Monday, the only emergency response units equipped to give transfusions before patients reached a hospital were LifeNet helicopter ambulances. They operate from five locations across the state with limited blood inventory.
“We know timing is everything,” he said.
Henry estimated that having the ability to transfuse patients at the scene or in a ground ambulance could have saved about 150 lives in the Omaha area over the past five years, or roughly 30 a year.
Military medics have used the technique for some time. The first civilian program came online in Texas in 2018 and use since has spread, particularly in the southern United States. A combat trauma surgeon, Henry is working at the Nebraska Medical Center as part of a partnership between Nebraska Medicine and Offutt Air Force Base .
“These are lessons that we learned,” he said, noting that prehospital transfusions can improve patient outcomes and recovery time in addition to saving lives.
Omaha Fire Chief Kathy Bossman said about 160 fire departments in the U.S. now offer the treatment, which “dramatically increases the chances of survival” for patients who experience severe blood loss.
The first transfusion was given shortly after the program launched to a woman who suffered a gunshot wound. “This program represents a significant breakthrough in how we respond to trauma and critical emergencies,” she said.
The Omaha Fire Department, which has 19 medic units, first studied call volume in the city and worked with Nebraska Medicine to determine where to place the blood supplies.
She said the department hopes to expand the program. Discussions already are underway with departments in Bellevue and Lincoln. But with blood supplies tight, first responders have to make sure they’re using blood appropriately. Medics follow a list of criteria to determine which patients would benefit from it.
Andreas Bierbrauer, the department’s EMS division chief, said it’s important that blood be administered within the first 35 minutes of such an injury.
The blood is transported and stored in portable intelligent refrigerators. While the top-of-the-line units look like reinforced coolers, they’re designed to keep blood between 2 degrees and 5 degrees Celsius and signal medics if the temperature deviates from that range.
If it does, it has to be discarded. The coolers, each of which costs about $12,000, plug into the ambulance’s power supply but have 75 hours’ of battery backup power in case power goes down.
Units of blood have to be returned and replaced every 10 days if they’re not used, he said. But even returned blood — the ambulances carry O positive, which represents 38% of the blood supply and can be safely given to most people — can be used in the emergency room or processed to remove plasma and other factors for other uses, as long as the “chain of cold” can be traced.
“We have to be good stewards of the blood,” Bierbrauer said.
Area blood banks frequently warn of shortages of blood, particularly during the summer months and around holidays. Officials encouraged residents to donate blood to meet the ongoing need.
“If you can do it,” Henry said, “please do it.”
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