Trial innovation helps recruitment

14 August 2020

A UK trial into the effectiveness of giving blood to trauma patients before they come to hospital has recently introduced an innovation that, if proven to be successful, could be adopted across the country.

Previously, only doctors could recruit patients to the RePHILL (Resuscitation with Pre-Hospital Blood Products) trial. The RePHILL team have developed a training course to enable paramedics to recruit and give blood to patients taking part in the trial.

Mark Beasley, The Air Ambulance Service (TAAS) Critical Care Paramedic, said: “I was excited but apprehensive when I learnt that paramedics would be authorised to recruit patients.

“The comprehensive training package and support provided by the RePHILL team meant I was confident in my ability to recruit, and I was left feeling that the patient had received the best possible care.”

The trial is sponsored by the NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC), who work closely with a number of regional ambulance services, with TAAS the first to train their paramedics to recruit patients.

Patients either receive blood before their arrival to hospital or the current standard care, saline, with the trial assessing whether the early use of blood could help to save lives.

Hazel Smith, Research Paramedic, added: “Giving blood to patients before they arrive in hospital is a fairly recent development in the UK, with the first patient receiving pre-hospital blood in 2012. Transfusion is traditionally decided by doctors. However, non-medical authorisation is increasingly being seen as an important advanced skill not only for nurses but also for the paramedic community.

“We believe we are the first team in the UK to support rolling this out within a clinical trial setting. Having more people who can enrol patients into RePHILL will really help with our recruitment and patient care.

“I’d like to thank my colleagues who helped develop the training programme and Dr Caroline Leech (TAAS Clinical Lead) for her support in rolling this training out within her team.”

Dr Heidi Doughty, Consultant Haematologist with NHS Blood and Transplant and a member of the RePHILL team, said: “Non-medical authorisation and research are both really important developments for the emergency community. The experience of these paramedics should help shape future training courses and pre-hospital transfusion trials.”

So far, two TAAS paramedics have recruited patients to RePHILL, which has recruited almost 400 patients overall.

Recruitment to the trial is currently ongoing and is expected to finish by the end of the year.