UW Health has introduced Type O whole blood transfusions on medical flights as part of its Whole Blood initiative, launched in late October. 

Whole blood is defined as the blood in its natural state, just as it flows through the body, with all its components intact and unseparated, according to the American Red Cross. 

Whole blood transfusions combine all the components that are typically administered separately, such as saline, packed red blood cells, plasma, and platelets, into a single solution. While convenient, whole blood is challenging to transport because of its fragility, according to the National Institutes of Health Clinical Center. 

UW Health Med Flight assistant Medical Director and physician Ryan Newberry said UW’s whole blood has a shelf life of 21 days. Blood on Med Flights are cycled every 14 days and return to UW so it’s able to be used before it is unusable. 

Platelets in whole blood are less fragile and can travel safely on Med Flight helicopters to critically injured patients far from a trauma center, Newberry said.

This new procedure in UW Health’s toolbox is transforming trauma surgery, creating a more efficient process, Newberry said. 

One in five critically injured patients involved in accidents will likely die within the first 24 hours in the United States, Newberry said. 

“By giving patients not merely blood transfusions outside of the hospital, but whole blood transfusions, we think that buys us time,” Newberry said.

Since the implementation, UW Med Flight has treated six to seven patients with Type O whole blood, Newberry said. 

In one instance, a patient was found far away from a trauma center bleeding to death from a gunshot wound to the abdomen. UW Med Flight gave them a whole blood transfusion and were able to stabilize and resuscitate the patient by the time they arrived at the trauma center, Newberry said.

Newberry said the use of whole blood in UW Med Flight gives trauma centers a head start in providing care for patients in critical condition. Instead of starting at ground zero trying to stabilize and resuscitate a patient, patients arrive ready to head to the operating room, Newberry said. 

Newberry highlighted rural Wisconsin as a unique challenge to emergency and trauma medicine services. Wisconsin has roughly 130 hospitals of which less than 10% are Level I or Level II trauma centers, Newberry said. 

“There’s a lot of distance with a lot of people. The clock is always running. [The Whole Blood Initiative] allows us to provide a higher level of care to patients that live further away from a trauma center,” Newberry said.

Acute care surgeon at UW Health and assistant professor for the Department of Surgery at the UW School of Medicine and Public Health Charles Shahan spoke on his participation in a hospital-wide coordinated team that brought whole blood to use at UW Health. 

The transition has made the entire process seamless, from the moment Med Flight arrives to when the patient leaves the operating table, Shahan said. 

Newberry said the switch to whole blood transfusions has been in development for decades, with research on its use dating back to World Wars I and II. 

Newberry said doctors in combat have historically administered whole blood transfusions directly from one soldier to another. This practice resurfaced in more recent conflicts, such as the Iraq and Afghanistan Wars, Newberry said. 

“We started noticing with all of the things we’ve learned from trauma, there’s platelets in that whole blood and the patients who are getting transfused with whole blood were having higher survival rates. They were doing much better,” Newberry said.

In the past six years, trauma centers have started using whole blood transfusions in civilian cases, adopting practices first seen in combat settings, Newberry said. 

UW Health is an early adopter of whole blood transfusions which required hospital-wide collaboration, Shahan said.

“This is a true team effort that goes all the way back to a dedicated group of blood donors who make this entire thing possible,” Shahan said.

Blood donors play a vital role in the life-saving process, as their contributions are essential to the success of the whole blood initiative, Shahan said

“I’d especially like to thank the people who donate blood to make any of this possible. The donor pool is often an overlooked part of this equation, but without them, we wouldn’t have anything to start with.” Shahan said.