New State Protocol Drafted by SLUHN Doc Saves Lives

Dr. Bryan Wilson helped draft Pennsylvania’s prehospital blood administration protocol late in 2023.

He saw its impact this spring.

St. Luke’s Bethlehem EMS fellow Ashley Woodrow was working with Suburban EMS in March when they encountered a patient suffering from hemorrhagic shock. With the patient located in a remote part of Mount Bethel Township, they couldn’t afford to wait until they reached the hospital to complete a blood transfusion.

Following the protocols Wilson championed, Woodrow, a member of the new St. Luke's EMS Physician Response Team, administered a prehospital blood transfusion that bought time as they transported the patient to St. Luke’s Monroe Campus. By reaching the scene of an emergency in its own specially equipped vehicle, the EMS Physician Response Team assists regional EMS agencies by bringing blood, advanced medications, and a physician to the patient's side when they need it most.

After the patient received additional blood, he was rushed to the operating room, admitted to the ICU after surgery and ultimately recovered to return home to family.

“For our program, this was our first time working with a partner EMS agency in the community where we were able to administer that blood product,” Wilson said during a recent phone interview. “There’s other programs in the state that had had successful administrations, but this was our first one.

“This patient was super, super sick. The outcome may have been very different if the patient had continued to bleed and had continued to become more hypotensive during the long transport time. By having that blood there, I feel very strongly it made a huge impact on the patient’s outcome, based on the information provided to me from the clinical team that was caring for the patient.”

Wilson had wanted to see blood available for EMS well before the current protocol went into place. When the Commonwealth EMS Medical Director expressed his support for prehospital blood administration a few years ago, Wilson had an opening to pursue a program. He realized there was more support when a St. Luke’s trauma surgeon, Dr. Max Braverman, mentioned blood in EMS during an emergency-room conversation.

When Wilson approached the state medical director, he received the go-ahead to develop a protocol. Wilson and a group of doctors from across Pennsylvania wrote and designed a proposal for a presentation with the state medical advisory committee, which approved the program. It went into effect in late 2023.

Wilson is working with St. Luke’s and a regional blood bank, Miller-Keystone, to figure out how to get blood available to more EMS agencies in the region.

“This is for us to be able to make an impact,” Wilson said of the program. “To save lives, make a difference in the communities we serve. These are projects I'm excited to work on.”

The St. Luke’s EMS Physician Response Team is available to assist regional EMS agencies by bringing blood, advanced medications, and a physician to the patient's side when they need it most.