Quick Access to Blood, Bleeding Control Training Saves Lives in Ventura County, California
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Firefighter and paramedic Max Corbiere and Fire Captain Edward Campana demonstrate the new blood transfusion program launched in Ventura County, California.
Quick access to bleeding control and blood transfusions can be lifesaving for patients with a severe bleeding injury, yet only about 1% of ambulances in the United States carry blood products. A new program in Ventura County, California, highlights the unique synergy between access to blood transfusions at the scene of injury and bleeding control training.
Since April, four of the five fire battalions with the Ventura County Fire Department are now equipped to supply blood transfusions at the scene of injury. The team estimates that up to seven trauma patients per month may benefit from this program.
“Having quick access to blood saves lives. Administering blood to patients in the field can improve patient outcomes and help keep them alive,” said Thomas Kobina Duncan, DO, FACS, an American College of Surgeons (ACS) Governor and trauma medical director at Ventura County Medical Center. “It is a program that is not necessarily restricted to trauma patients, but it’s also one that can be used for anyone with severe bleeding complications, which may include pregnant patients or patients who have gastrointestinal bleeding.”
The program, which was launched with the help of grant funding, is thanks to collaborative grassroots efforts involving the Ventura County Fire Department, Ventura County EMS Agency, California EMS Authority, and the Ventura County Medical Center.
The program is especially beneficial for the vast landscape in Ventura County, located about 65 miles northwest of Los Angeles. Two ACS-verified level II trauma centers situated on the east and west sides of the county treat the majority of the county’s trauma patients. However, even with two dedicated trauma centers, emergency response times average 8 to 10 minutes and can be longer in certain areas, according to Dr. Duncan. The blood transfusion program can fill critical gaps when minutes matter the most, he added.
Simultaneously, ACS Stop the Bleed training has been an important component in trauma education in Ventura County for several years. Junior lifeguards, high school students, and EMS personnel are trained in bleeding control efforts that teach basic steps to apply to someone who is bleeding before first responders arrive and before a patient can be transported to a hospital.
The Ventura County Medical Center Trauma Bay treats a trauma patient who benefited from the county’s pre-hospital blood transfusion program.
The Lifesaving Power of Blood in Action
Recently, the important combination of access to blood and bleeding control was made apparent when a stabbing victim arrived at the Ventura County Medical Center. Paramedics first applied bleeding control measures to the victim, who was stabbed in the thigh, and after realizing the wound was too severe to be effectively controlled, they administered blood at the scene. This combination, Dr. Duncan said, was critical in saving the victim’s life and preventing the patient from progressing into a worse state of shock.
Dr. Duncan has also seen the benefits in several other patients, including a patient who arrived with significant bleeding in the gastrointestinal tract from erosive gallstones and underwent surgery after receiving blood.
“Data shows that when you resuscitate a patient and administer blood in the field, you in effect can reduce the amount of blood needed [if the injury were to become more severe] and save that blood for other patients who may require it,” Dr. Duncan said.
ACS Stop the Bleed training with Ventura County Junior Lifeguards in 2024.
Access to Whole Blood: More than Half the Battle
Although the clinical value of prehospital whole blood, which refers to blood administered at the scene of injury that has not been separated into its component parts, is well-recognized and has been used in the military for decades, access to blood in the civilian setting is limited. Barriers include financial and state regulations.
Randall Schaefer, DNP, RN, ACNS-BC, CEN, a retired Army trauma nurse and president of the Prehospital Blood Transfusion Coalition, refers to prehospital blood as a “team sport” that requires engaging partners early on, including collaborations from blood banks and trauma teams.
“We have an opportunity to save lives. Trauma care doesn’t just happen in one place. It involves a continuum of care from the minute bleeding starts until the minute a patient can receive more definitive care at a hospital. I think that’s a concept that the military has done really well, but the civilian world has not yet quite adopted it,” she said.
A 2017 study published in JAMA found that the prehospital transfusion of blood products within 36 minutes after injury in a military combat setting was associated with greater survival at both 24 hours and 30 days post-injury compared to patients who received a blood transfusion later or did not receive any transfusion.
Dr. Schaefer, who consults with teams across the country to start prehospital blood programs and consulted with Ventura County on its program, emphasizes that training to reduce bleeding deaths is just as vital as other first aid training.
“I would argue that we need to treat access to blood like cardiac arrest,” she said. “Bystanders are trained to call for help and administer CPR or use an AED. In the same way, Stop the Bleed can be administered in bleeding emergencies, and emergency medical first responders can launch blood as soon as possible to save lives.”
