It's groundbreaking, it has never been done before in Canada, and hardly anywhere else in North America, and yet it's happening in Regina, and Saskatoon by the end of the year.
The Shock Trauma Air Rescue Society (STARS) has become the very first air medical service in Canada to stock blood on their helicopters for life-saving transfusions, while transporting a patient to hospital.
Allowing the helicopter medical staff to begin a blood transfusion early is a life-saving innovation.
"This will improve the speed and effectiveness of emergency care for patients outside major urban centres," said Rural and Remote Health Minister Randy Weekes in a media release.
The first hour of emergency care has been dubbed "the golden hour" because lives can be saved if a critically injured patient is stabilized before arriving at a trauma centre.
Take Humboldt for instance.
Dr. Karen Dallas, medical director of transfusion medicine for the Saskatoon Health Region (SHR) and northern half of the province, said not only can this new implementation potentially save the life of a Humboldt-area resident, but any other victims from other rural locations brought to the Humboldt District Health Complex for assessment.
"Many times, a patient brought to a hospital in a more-rural area, like the one in Humboldt, will need more intensive treatment that the Humboldt hospital may not be staffed or equipped to handle. So they'll be sent onward to a trauma centre in Saskatoon, by the STARS helicopter," Dallas explained.
As well, Dallas said that most hospitals or smaller clinics in scarce, rural areas only have about two units of blood stocked for "just in case" emergencies, not nearly enough to help a victim of a serious, critical injury.
"I've seen some victims go through over 100 units of blood in one day for a transfusion," Dallas said. "So only two units at a hospital is nothing. It can't do anything for more serious matters."
The STARS helicopters in Regina currently stock two units of O negative blood from the Regina General Hospital's transfusion lab, which is more than enough to give to the patient while en-route to a larger trauma centre which can provide more; the STARS helicopters in the SHR will be following suit by the end of December, stocking blood from the transfusion wing of Royal University Hospital.
"When we looked at all the statistics, we realized we've got to do this," Dallas said. "It shouldn't have taken so long but that's because most medical bodies and professions don't come together on issues; they don't share stats or facts, and they don't look at the benefits of addressing certain problems, only the risks."
Dallas is talking about her collaboration with Dr. John Froh, medical director for STARS Saskatoon.
It was Froh who made Dallas aware of the urgency in stocking air medical service with units of blood.
"After all the stats and trends he showed us [at a roundtable discussion between the two bodies], it just hit me in the face. This is an important patient-first priority," Dallas said.
Froh revealed that in many Saskatoon-area cases where STARS was involved, there wasn't enough time to stock blood on the helicopter before arriving at a trauma scene.
"He said there were so many times where before even leaving the ground, he knew that this type of injury or accident would require a blood transfusion, as soon as possible," Dallas said.
"But you need to get to the victim right away, so there isn't enough time to wait and stock blood on the helicopter, because every second the victim isn't being tended to is critical."
That's when Froh emphasized the need to adopt Regina Qu'Appelle Health Region's STARS initiative of permanently stocking blood onboard.
Dallas added there were other factors that made the implementation of this type of care nearly impossible, until now.
STARS was formally established in 1988, when it was integrated into emergency planning for the Calgary Winter Olympics, but wasn't established in Saskatchewan, in the cities of Saskatoon and Regina, until 2012. Before that, the province used a different type of air ambulance but didn't have the type of medical personnel onboard to administer blood transfusions.
"Everything is very different nowadays, ever since the AIDS crisis. Transfusion medicine has become a heavily regulated field and you need the right physician to administer it," Dallas explained.
The right physician which, until 2012, was not available on air ambulances prior to the establishment of STARS in Saskatchewan.
However, now that STARS helicopters are staffed with advanced life support paramedics, critical care nurses and emergency physicians, blood transfusions can finally be administered.
Right now, the SHR is finalizing logistics and testing, before officially equipping its STARS helicopters with units of blood.
"We're validating the coolers - testing them out for a few days, in cold weather, at room temperature, humid weather, to see its effect on the blood's viability," Dallas said.
STARS uses ultra-coolers to store the blood onboard, keeping it at a specific 1-6 degrees Celsius, the ideal temperature to preserve blood's usability.
The STARS unit in Regina keeps blood aboard their helicopter for 72 hours, after which, if not used, it's swapped out for new units of blood; STARS Saskatoon is determining the limit for their coolers to maintain optimal temperature, probably around the 72 hour mark as well, Dallas said.
So it seems by the end of the year, residents of rural areas like Humboldt, and the greater Saskatoon vicinity, can feel a little more at ease knowing if they were ever involved in a serious accident requiring STARS, they'd be one step closer to life, than death, than has ever been possible in the country.
