Air Ambulances UK

SWIFT TRIAL

A trial of the clinical and cost-effectiveness of pre-hospital whole blood administration versus standard care for traumatic haemorrhage.

The NHS Blood and Transplant study will look at whether giving another product instead of red blood cells and plasma pre-hospital will:

– Reduce the number of deaths 24 hours after injury

– Reduce the need for further large blood transfusions when patients get to hospital

The product that will be given is called whole blood (WB). It contains red blood cells, plasma and platelets (which help with clotting) all in one bag.

Participants recruited so far: 760/848

Background

Air Ambulance charities across the country attend accidents or incidents in the community to treat patients who are severely injured or unwell. This is a study about Air Ambulance charities giving blood transfusions to patients before they arrive at hospital (pre-hospital) when they have life-threatening bleeding.

The Swift Trial, funded by the Ministry of Defence and NHS Blood and Transplant (NHSBT), aims to investigate the most effective way to administer blood transfusions and determine which blood products to use for these patients.

NHS Blood and Transplant know that early blood transfusion improves the number of patients that survive who are bleeding like this, but the best way to do this and what blood products to use is not clear.

Not all Air Ambulance charities give blood products, but those who do transfuse patients with red blood cells and plasma. These blood products are made from blood donations and come in different treatment bags, with certain requirements for temperature when they are being stored and carried in the helicopters or rapid response cars.

They also have to be given separately, one after the other to the patient. In addition, carrying these blood product bags can add significant weight to the kit bags that the medical teams carry.

About the SWiFT Trial

This study will look at whether giving another product instead of red blood cells and plasma will be better at reducing the number of deaths 24 hours after injury, and reduce the need for further large blood transfusions when patients get to hospital.

This product is called whole blood (WB). It contains red blood cells, plasma and platelets (which help with clotting) all in one bag.

Although there is some evidence of benefit with the use of WB, there have been no studies exploring the clinical and cost effectiveness of pre-hospital administration of WB versus the standard care for bleeding trauma patients in the UK setting.

In 2019, NHS Blood and Transplant carried out a survey of UK Air Ambulance charities and their thoughts about giving WB to patients. In this survey, 82% said that WB would be their preferred blood component, followed by red cells and plasma in one bag (65%), and red blood cells and thawed plasma and platelets (in different bags) (30%). All those who responded said that they would like to see a clinical trial being carried out, before it was given widely in the NHS and would support this work.

SWiFT Trial Logo

What the SWiFT Trial are hoping to find

It is important for patients, healthcare professionals and blood services that the clinical and cost effectiveness of pre-hospital WB transfusion is looked at in a large trial before it is rolled out in the NHS, as we have a unique national health service in the UK.

The production of WB could potentially affect the supply of blood components required to treat other patients, as a unit of WB cannot be used to then manufacture other components.

However, it could also be argued that early transfusion of WB may reduce the need for further blood transfusions when patients arrive at hospital, due to earlier control of their bleeding. The study will allow us to look at all these uncertainties.

The study began in December 2022 and will last for two years.

If you have any queries about the study, you can contact the SWiFT trial team at SWIFT@nhsbt.nhs.uk.

Jude Morris Innovation & Development Fund

Magpas Air Ambulance received £10,000 for the Swift Blood Trial from The Jude Morris Innovation and Development Fund aiming to simplify trauma patient transfusions by studying the effectiveness of whole blood usage, potentially improving outcomes for serious injuries. Midlands Air Ambulance Charity secured £4,080 to train clinicians in advanced pre-hospital ultrasound techniques, enhancing patient care and potentially saving lives through tailored treatments and interventions.

To find out more about the Grants Awarded from The Jude Morris Innovation and Development fund click here

Charities taking part in the SWIFT Trial:

FAQ’s for participants

You can read more about the SWiFT Trial on the NHS Blood and Transplant website here: https://www.nhsbt.nhs.uk/clinical-trials-unit/current-trials-and-studies/swift/

There are no known risks linked to/attributed to taking part in this study, and there are no known additional risks in participating in the study compared to the risk associated with transfusing blood components.

However, information collected as part of your participation in this trial may benefit patients in the future, even if you were randomly allocated to the standard treatment group.

If you have any questions for the researchers or would like further information, please do feel free to get in touch with the research team by emailing SWIFT@nhsbt.nhs.uk