Pittsburgh EMS expands pilot program for paramedics to utilize mobile blood banks

It didn’t look good for the teenage driver.

Shortly after 7:15 a.m. on a rainy Thursday in May last year, the young man — who lost control of his yellow sports car when it hydroplaned on Saw Mill Run Boulevard and he slammed the vehicle into a utility pole near the Pittsburgh/Whitehall border.

He was badly injured and losing blood as first responders and Duquesne Light workers struggled to free him from what was left of his car.

Then, Pittsburgh paramedics — working alongside firefighters from Pittsburgh, Whitehall and Pleasant Hills — did something no ground-based EMS unit previously had done in Pennsylvania: they connected the driver to an IV and administered two to four units of whole blood right at the scene.

EMS rushed the teen to an area hospital in critical condition — and he survived.

“It was a prolonged entrapment, he was pinned there for about an hour,” said Pittsburgh EMS Assistant Chief Mark Pinchalk, who didn’t respond to the call that morning. “He had significant pelvic injuries, which you can die from.”

“We really feel the blood helped save that kid’s life.”

Pittsburgh EMS is working to expand the pilot blood program it launched in 2023. A recent state Department of Health change in “prehospital protocol” guidelines green-lighted EMS units throughout Pennsylvania to carry and administer blood.

“Prior to this protocol, Pennsylvania’s air ambulances and some physician response vehicles were providing field blood,” health department press secretary Mark O’Neill. “Ultimately, additional lives could be saved when paramedics have access to whole blood and the ability to administer whole blood during emergency responses or in transport to a hospital.”

Two UPMC hospitals will provide paramedics with the blood supply, and other operating costs are minimal, EMS officials said.

One of the service’s two rescue-unit ambulances will store the blood during shifts in a military-grade cooler; when the cooler loses power, its battery can keep the blood cool for up to 72 hours. A grant helped the group buy the $10,000 cooler.

On Wednesday morning, Pittsburgh Public Safety Medical Director Dr. Leonard Weiss walked six Pittsburgh paramedics through the mechanics of mobile blood transfusions, as they sat in a brick- and tile-walled Strip District training room with three first-aid dummies.

Last year, Pittsburgh EMS needed physicians like Weiss to administer blood at accident scenes, Pinchalk said.

Not anymore.

Wednesday’s group, culled from a larger cohort of 24 Pittsburgh paramedics taking “master clinician” training, expects to travel regularly with blood in their ambulance by summertime.

It is unclear how many EMS units in the state are making plans to conducting training to carry blood on ambulances. The state Department of Health didn’t respond this week to numerous emails and phone calls seeking comment.

In Westmoreland County, Mutual Aid is participating.

Earlier this week, Weiss — bespeckled and in a white dress shirt, often holding up a clear bag filled with red-dyed liquid, which stood in for blood — paced the room, mixing medical terms with straight-forward descriptions about heat-of-the-moment decisions that paramedics will make about blood transfusions in an emergency.

(Pro tip, Weiss said: remember to flush a victim’s IV with 1 cc of saline before giving blood to ensure their veins are expanded.)

Weiss also detailed the minutia — small but important numbers on each bag’s white sticker — such as where to find the type of blood a bag is carrying, as well as its expiration date.

“The less we can do, the better — if you have to add equipment, we only do it because we have to,” said Weiss, after a paramedic plunged the red dye into an IV connected to the training dummy with a piece of paper reading “Gustav” taped to his forehead.

“Time is of the essence!”

Hemorrhaging from a traumatic injury — in short: losing so much blood that body tissue isn’t replenished with enough oxygen — is the leading cause of death for Americans, ages 1 to 46, according to the National Institutes of Health.

The numbers sound harrowing — and EMS units are in position to help, said Gary Watters, an Altoona-area paramedic for 38 years who also serves as president of the Ambulance Association of Pennsylvania.

“Treating traumatic hemorrhage is a game-changer,” Watters told TribLive. “Think about it this way: you want to replace what (a victim) is bleeding out … By giving whole blood, it allows the body to be oxygenated and it promotes improved functioning.”

“Whole blood” is blood drawn directly from the body that hasn’t had plasma, platelets or red and white blood cells removed from it.

About 85% of the 30,000 potentially preventable deaths reported each year in the U.S. happen before the patient even arrives at a hospital, researchers reported in a 2022 study in the “Prehospital Emergency Care” journal.

And hemorrhaging — often caused by “penetrating wounds” from knifes or gunshots — does not discriminate.

Mortality rates for children suffering traumatic hemorrhaging, to boot, are more dramatic than their adult peers, research shows.

About 1 in 4 children who suffer traumatic hemorrhaging die within 24 hours, and more than 1 in every 3 die within 28 days, the study found. By comparison, the same diagnosis is a death sentence for 1 in 5 adults.

Pinchalk, the EMS chief, believes making blood transfusions mobile and highly available through paramedics will make a difference in Pittsburgh.

Pittsburgh EMS had a 94% survival rate in 2023 — 97.9% if you exclude victims who suffered significant head injuries, Pinchalk said.

The survival rate was 75% in 2023, though, for those suffering from torso wounds who had become hypotensive — their blood pressure dropping or not able to be measured, Pinchalk said. That’s often people who suffer from the penetrating wounds from knife attacks and gunshots.

Pinchalk said the new blood initiative also will improve survival rates for women suffering from trauma-related postpartum hemorrhaging, or victims suffering from extensive gastrointestinal bleeding.

When it comes to car crashes, 2023 provided Pinchalk with lots of anecdotal evidence about the benefits of the new blood initiative.

In March last year, a young woman was driving in Pittsburgh’s East End when her car collided with a bus, Pinchalk said. She was trapped in her car and her blood pressure plummeted. She had fractured her pelvis and leg, and injured her liver and spleen.

Pittsburgh EMS hooked up the young woman to an IV and gave her one unit of blood before taking her to the hospital, Pinchalk said.

She survived.

In May last year near the border between the City of Pittsburgh and the South Hills suburbs, a younger woman crashed her car into a utility pole, Pinchalk said. She injured her aorta — if ruptured, she would have died quickly — and her spleen, liver and parts of her kidneys.

Paramedics extricated the trapped driver and gave her oxygen and whole blood, Pinchalk said.

She survived.

“In 2023, physicians had to be on scene,” Pinchalk told TribLive. “Now, the paramedics will be able to (administer blood). It’s going to make it logistically easier to get blood to the people.”