Archive for Thursday, November 17, 2005

Blood study to draw on county residents

EMS to participate in research

November 17, 2005

Leavenworth County ambulances soon will begin carrying synthetic blood.

The move is part of a nationwide research study in which emergency workers in designated counties will give PolyHeme, a synthetic blood product, to one of every two patients who are bleeding severely.

PolyHeme, which replaces lost blood volume and hemoglobin, or red blood cells, can be given to a patient at the scene of an accident or on the way to the hospital.

Patients who will receive PolyHeme will be selected at random. The patients not selected to receive PolyHeme will receive saline solution, which does not carry red blood cells. The trial would affect only patients who will be taken to the University of Kansas Hospital in Kansas City, Kan. The hospital is one of about 30 Level 1 trauma centers in the country that is participating in the study.

Jamie Miller, interim director of Leavenworth County Emergency Medical Service, said he's pleased the county would be participating in the study.

"Even though it is just a study, it may be something we do in the future that changes the standard of care," said Miller, who's been a paramedic for five years and with the county's EMS since 1996.

Recipients of PolyHeme must be at least 18 and they should be Kansas residents, Miller said.

Miller has completed training in the use of PolyHeme at the University of Kansas Hospital. And early next month after training of other county paramedics, he said, the county's ambulances would be equipped to carry PolyHeme.

The synthetic blood is compatible with all blood types and does not cause transfusion allergic reactions, Miller said.

Three-county area

Leavenworth County counselor David VanParys said use of synthetic blood could be a significant leap in health care.

"If you think about it, using just a saline solution can help stabilize you, but this synthetic blood can be used in much more emergency situations by our EMS staff, and it could save lives," VanParys said.

Dr. Michael Moncure, medical director of trauma at the medical center, agreed. Moncure is the KU physician overseeing the study, which in this area also encompasses Douglas and Wyandotte counties. Johnson County Commissioners voted against participation in the study.

"What this research study is truly looking at is giving this product in the prehospital environment and giving the patient the opportunity to carry oxygen within their blood as opposed to just filling up that space with fluid," Moncure said. "It will increase the likelihood of saving lives or preventing organ damage."

Trials of PolyHeme have shown that in worst-case scenarios, patients who were losing all of their own blood received as many as 20 units of PolyHeme and survived, Moncure said.

In the study, individual patients would be able to receive a maximum of six units of PolyHeme, Moncure said.

Recycling donated blood

PolyHeme extends the usefulness of a precious commodity - donated blood - which only has a shelf life of 42 days, Moncure said.

PolyHeme is manufactured from expired blood bank blood that would have been thrown away. That's where Northfield Laboratories, of Evanston, Ill., comes in.

"They (blood banks) give that blood to Northfield, it is broken down, they take away the cellular envelopes around the hemoglobin and take that hemoglobin and wash it and sterilize it," Moncure said.

When refrigerated, PolyHeme has a one-year shelf life.

Future standard of care

Moncure predicted that synthetic blood given at the scene of accidents would be the standard of care in the future.

"Trauma is the leading cause of death up to age 45 by far," Moncure said. "... Certainly (with PolyHeme) there is the opportunity to save some of the people in the 45 minutes to an hour who are bleeding until they can get to a trauma center and receive care. Even if you start replenishing the blood, by the time you get to a trauma center or hospital, it's oftentimes too late because the organs have been through an oxygen debt."

Moncure said this was a "waiver-of-consent" study. In other words, ambulance personnel can use PolyHeme without asking for patients' consent. Those who do not want to participate can wear a blue opt-out bracelet. To receive a bracelet, individuals can contact study coordinator Suzanne Porras at (913) 588-3005 or sporras@kumc.edu.

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