Partnering with UM Medical Center, Maryland State Police helicopters now carry whole blood for transfusion

Whole blood is now available for emergency transfusions on all Maryland State Police helicopters, due to a public-private partnership announced Monday between the University of Maryland Medical Center, Maryland Institute for Emergency Medical Services and Maryland Department of State Police.

As part of the “Blood on Board” project, each state police helicopter carries two units of whole blood, or blood that has not been separated into its components — red blood cells, white blood cells, plasma and platelets. Whole blood, which was used in early blood transfusions, has recently been rediscovered for its clotting capabilities and is the product of choice at the country’s top trauma centers for resuscitating patients with extreme bleeding.

“This is a wonderful day for Maryland,” said Ron Cummins, senior vice president and chief operating officer for the University of Maryland Medical Center, at a news conference Monday. “This is the start of a new chapter of saving lives in Maryland.”

To minimize the possibility of any blood being wasted, the program employs three coordinators, who track the transportation of blood from the medical center’s blood bank to the seven Maryland State Police Aviation Command bases. Whole blood units will be stored in temperature-controlled coolers at each hangar for seven days, then unused units will be sent back to the medical center before they expire.

The Blood on Board project began with a test run in May, placing blood aboard Trooper 1 — based at Martin State Airport in Baltimore County — and Trooper 2, based at Joint Base Andrews in Prince George’s County. Before the program’s launch, Maryland State Police crews underwent extensive training, and a protocol was developed for deciding which patients would benefit from whole blood.

The project was expanded to the remaining five Maryland State Police Aviation Command bases in July, said Dr. Douglas Floccare, the MIEMSS state aeromedical director and medical director for the Maryland State Police Aviation Command.

The initiative — first raised as a possibility in 2016 — already has saved lives, he said at the news conference.

As of Monday, state police troopers had administered whole blood to 23 trauma patients, many of whom were victims of motor vehicle crashes, gunshots or entrapment under heavy machinery.

Four patients stand out to Floccare: a man who drove his motorcycle into the back of a stopped vehicle, a woman who was run over by multiple cars, a man who was driving a motorcycle and was struck by a car, and another man who was ejected from a car that rolled over.

“All four of these patients were unconscious with blood pressures ranging from the 40s to the 50s, with correspondingly fast heart rates,” Floccare said.

Ideally, a patient’s blood pressure should rest between 90/60mmHg and 120/80mmHg, according to the National Health Service.

“Prior to our ability to administer blood, these are the types of patients who would typically go into cardiac arrest and die before we reach the hospital,” Floccare continued. “All four of these patients responded to blood, survived to receive treatment and are currently in various stages of recovery, due to the excellent trauma-centered care that they’re receiving.”

After reviewing data from the past five years, Floccare found the Maryland State Police Aviation Command transported an average of 77 patients each year who went on to receive blood transfusions within 15 minutes of their arrival at the hospital. He estimated that the command has about one or two patients each week that could benefit from receiving a whole blood transfusion.

When it comes to trauma injuries, it’s important to remember that the “clock starts ticking” at the time of injury, not the time of hospital arrival, said Dr. Thomas Scalea, physician-in-chief of UMMC’s R Adams Cowley Shock Trauma Center, at the news conference.

“Being able to limit shock before we get to the point where the wheels fall off the machine is really a very, very important thing,” Scalea said. “To me, this is just Shock Trauma out in the field. And we are just delighted to be able to be part of this program.”