As the Trauma Medical Director at St. Anthony Hospital in Lakewood, Colorado, Dr. Johannigman is on a mission to bring whole blood to the forefront of trauma care in the Centennial State.
Emerging research reveals that whole blood outperforms fractionated blood components for these patients, capturing the attention of the trauma and surgery communities. In trauma centers, minutes can mean the difference between life and death.
According to NIH, Each minute’s delay in blood cooler arrival for adult trauma patients requiring massive blood transfusion increases the odds of mortality by 5%. Establishing blood banks in remote regions is a strategy for reducing delays in transfusion in time-critical settings.
A Brief History of Blood Transfusion
Blood transfusion, the process of receiving blood or blood products intravenously, is a medical practice that dates back centuries. In World War II, blood transfusion became more widespread and standardized, and it remained a common practice during the conflicts in Korea and Vietnam. Over time, this life-saving technique has evolved significantly thanks to advances in medical science. Whole blood contains red blood cells, plasma, and platelets, which has been crucial in trauma care.
The Reemerging Role of Whole Blood
In the military, when there was a need for whole blood, they tapped into walking blood banks. Since service personnel were already screened for transfusion risks and classified by blood type, uninjured soldiers with the appropriate blood types would provide whole blood.
However, in civilian life, lining up donors in the hallways of trauma centers would be impractical and unlikely to meet the scrutiny of overseeing and regulating agencies, including the US Food and Drug Administration (FDA), for the blood supply.
In modern medicine, blood is often separated into its components – red blood cells, plasma, and platelets – to address specific medical conditions. However, Dr. Johannigman firmly believes in the importance of whole blood.
Access to whole blood is limited in many areas, including remote mountain towns like Aspen, Colorado. While blood components serve a vital purpose in many situations, there are moments when nothing beats the life-giving power of whole blood. This is especially true in trauma cases where time is of the essence.
Ensuring Remote Communities Have Access to Life-Saving Interventions
The challenge in remote mountain communities is clear. These regions are not always easily accessible, and transporting blood products on time can be difficult. Inclement weather, challenging terrain, reduced visibility, and a scarcity of rescue personnel and transportation choices can impact patient outcomes. This is where whole blood steps in as a game-changer.
By introducing whole blood into Colorado’s healthcare landscape, Dr. Johannigman envisions a significant improvement in trauma care, particularly in areas like the mountains where access to blood products can be challenging. In emergencies, every second counts. A readily available supply of whole blood can differentiate between life and death.
Dr. Johannigman’s vision aligns perfectly with the broader goal of enhancing healthcare outcomes and ensuring that no patient’s life is compromised due to inadequate resources.
San Antonio’s Success Story
Since 2018, the San Antonio Whole Blood Collaborative has actively provided LTO + WB throughout Southwest Texas. They initially implemented remote damage control resuscitation and later expanded their services to include in-hospital trauma resuscitation, pediatric trauma resuscitation, obstetric hemorrhage, females of childbearing potential, and non-traumatic hemorrhage.
Furthermore, the program actively transfuses whole blood to individual patients as part of the region’s emergency response system. It also actively supplies whole blood for mass casualty events, such as the May 2022 elementary school shooting in Uvalde.
San Antonio, Texas, has been a pioneer in whole blood usage. The impact on patient outcomes has been remarkable. Recognizing the positive results in San Antonio, Dr. Johannigman aspires to replicate this success in Colorado.
As the overseer of St. Anthony’s Level I Trauma and Emergency General Surgery program, Dr. Johannigman is well-positioned to make this vision a reality. His expertise and leadership in the field make him the ideal candidate to spearhead establishing a robust whole-blood program that caters to the unique needs of Colorado.
Addressing the Fears
As with any significant change in medical practice, there are concerns to address when introducing whole blood. Some of these include:
- Universal versus Type-Specific Blood: One debate revolves around whether to use universal donor whole blood, which can be administered to any patient or type-specific whole blood, which matches the patient’s blood type. Both options have their merits and challenges, and Dr. Johannigman’s experience will be invaluable in finding the right balance.
- Rh+ Whole Blood versus Rh- Whole Blood: The Rh factor, a specific protein found on the surface of red blood cells, also plays a role in blood transfusion. Dr. Johannigman and his team must navigate the complexities of this factor in their mission.
- Using Whole Blood in Children: Children have unique medical needs, and applying whole blood in pediatric cases requires careful consideration. Dr. Johannigman will address these concerns to bring whole blood to Colorado.
Dr. Johannigman: Behind the Mission
Dr. Jay Johannigman is not just a medical practitioner but a seasoned veteran with over 35 years of experience as a trauma and critical care surgeon. His journey through medicine began with an AB degree in biology from Kenyon College and continued with a Doctor of Medicine degree from Case Western Reserve University.
In addition to his medical expertise, Dr. Johannigman holds the rank of Colonel in the US Army Reserve, where he has received numerous awards for his service, including the Legion of Merit, the Bronze Star, the Army Commendation Medal, and the Meritorious Service Medal.
Dr. Johannigman has held significant positions throughout his career, including Trauma Medical Director and Chief of the Institute of Military Medicine at the University of Cincinnati Medical Center. He is also a founding member of the Cincinnati Center for the Sustainment of Trauma and Readiness Skills (Cincinnati CSTARS).
Conclusion
Dr. Jay Johannigman’s mission to bring whole blood to Colorado is a testament to his commitment to improving trauma care and saving lives. With a wealth of experience and a visionary outlook, he is well-equipped to navigate the challenges and make whole blood a staple in Colorado’s healthcare landscape.
As we continue to witness the evolution of medical practices, pioneers like Dr. Johannigman remind us of the boundless possibilities for improving patient outcomes. The introduction of whole blood in Colorado could revolutionize trauma care, ensuring that those in remote mountain communities can access the life-saving interventions they desperately need
