The Study of Whole blood In Frontline Trauma (SWIFT) clinical trials began on 15 December, and are being led by NHS Blood and Transplant, in partnership with the UK Ministry of Defence and Air Ambulances UK. The scheme also includes 10 regional air ambulance charities:
- Air Ambulance Kent Surrey Sussex
- Dorset and Somerset Air Ambulance
- Essex and Herts Air Ambulance
- Great North Air Ambulance
- Great Western Air Ambulance
- Hampshire and Isle of Wight Air Ambulance
- London’s Air Ambulance
- Magpas Air Ambulance
- North West Air Ambulance
- Thames Valley Air Ambulance.
London’s Air Ambulance is the first charity to launch trials. The scheme will be rolled out to the other nine air ambulances over the next few months, and will be carried out over a two-year period.
The SWIFT scheme aims to recruit 848 patients to participate in the trials, to be divided into two separate groups. One group of patients will continue to be given transfusions of red blood cells and plasma separately, with platelets given separately if needed upon arrival at hospital. The second group will be given transfusions of whole blood. The trial will compare survival, and the amount of blood needed, over the first 24 hours after injury.
All blood used will come from O Rh negative ‘universal’ donors.
The benefits of whole blood may be due to platelets
UK air ambulances have carried blood products since 2012, but have previously been limited to separate packs of red blood cells and plasma. The scheme aims to determine whether the use of whole blood onboard air ambulances could reduce trauma deaths in patients.
The NHS noted in a statement that previous tests, such as on military casualties in Afghanistan, have indicated that whole blood could offer a greater chance of survival, alongside generally better outcomes for patients. Additionally, carrying and transfusing just one blood product could be ‘lighter and simpler’, enabling faster treatment.
The statement elaborated: “Whole blood may work better because it contains platelets … cell fragments which help the blood to clot. Platelets are difficult to store – they have a short five-day shelf life, must be stored between 20°C and 24°C, and need constant gentle movement to help them stay oxygenated. This means they are very difficult to use outside of hospitals. Currently, Air Ambulance patients, and soldiers needing battlefield transfusions, can receive plasma and red blood cells, but not platelets.”
In the US, Florida’s First Flight air ambulance announced that it was carrying whole blood on its helicopter in June.