Introducing innovative emergency medical response capability to serve residents of rural communities

Through its clinical affiliation with UPMC, Washington County Ambulance and Chair EMS is now one of the first emergency medical services (EMS) organizations in the region that is specially trained and equipped to carry blood on ambulances and administer blood in the field.

“Our ability to administer blood before a patient arrives at the hospital is increasing access to rapid, life-saving care,” said Larry Pollock, executive director, Ambulance and Chair EMS. “This is especially important for our predominantly rural communities that are a greater distance from the nearest hospital or trauma center. This will increase survivability of people suffering significant trauma and medical emergencies.”

Studies have shown that patients in life threatening bleeding situations have the best possibility of survival when they are administered blood. The sooner the administration, the better the chance for survival.

Late last year, a legislative change was made by the Pennsylvania Department of Health’s Bureau of Emergency Medical Services indicating Pennsylvania Statewide Advanced Life Support Protocols now allow for specially trained paramedics to administer blood in the field, a procedure previously reserved for EMS physicians and air ambulance crews. Prior to this change, the only treatment available to paramedics in the field for Advanced Life Support calls was administering intravenous normal saline. For patients who are bleeding with traumatic injuries or complex medical conditions, administration of Type O blood is lifesaving.

“Working together for the betterment of the community, this is made possible through our close collaboration with the UPMC Prehospital Care Program, Vitalant — our regional blood supplier, EMS West — within the Pennsylvania Department of Health’s Bureau of Emergency Medical Services, UPMC Washington’s Laboratory Management team and the expert paramedics and prehospital registered nurses of Ambulance and Chair EMS,” said Larry Pantuso, vice president of Strategy and Clinical Services, UPMC Washington, and board chair, Ambulance and Chair EMS.

In many parts of the country and the state, carrying blood on ground ambulances is still a novel development. Ambulance and Chair’s clinical partnership with UPMC brings the advanced protocols needed that are enabling this life-saving capability.

“At UPMC, when we see a need in the community, we look to see how we can make a difference,” said Vincent Mosesso, M.D., medical director, UPMC Prehospital Care and chief medical officer, Ambulance and Chair EMS. “We are grateful for the opportunity to help make a difference for people in Washington County and surrounding communities, before they get inside a hospital.”

Just in the first week of the new program, two emergencies required administration of blood in the field — a post-partum hemorrhage at home, and a near-fatal motor vehicle accident. In these situations, critical blood supply was administered before arrival at the hospital.

“We are equipping our paramedics with another tool to save lives,” Dr. Mosesso continued. “An emergency department or trauma center can be many miles away, and minutes matter when it comes to saving lives. We’re grateful for the state’s guidelines — empowering paramedics to take action that can mean the difference between life and death.”

EMS is no longer just transporting patients, it has become a complex system of innovative medical care.

“This program has required a substantial investment of time, equipment and training hours for all involved in taking this next step in combating morbidity and mortality related to significant blood loss,” said Pantuso. “Ambulance and Chair EMS is thrilled to be a part of making history in the evolution of advancing emergency medical response.”