NSW Retrieval Transfusion

Mrs Sophie Shand1

1NSW Ambulance Aeromedical, Australia



Catastrophic haemorrhage is identified as the leading preventable cause of death. Rural and remote communities are particularly challenged by their distance to definitive care. NSW Ambulance has developed and introduced a Retrieval Transfusion Protocol to facilitate the delivery of blood products to pre-hospital scenes, during extended transfers and to hospital facilities.

Your Project:

There is limited evidence for transfusion specific to the pre-hospital environment however recent robust studies in hospitals broadly supports mixed transfusion in 1:1:1 ratios (Shand et al., 2018). NSW Ambulance Aeromedical services currently routinely carry only Packed Red Blood Cells and there are limited facilities which have access to additional products, particularly in rural and remote areas. With approximately 35 per cent of the NSW population residing beyond the boundaries of the greater Sydney area, NSW Ambulance has developed and introduced a retrieval transfusion protocol which facilitates the provision and delivery of additional blood products from existing blood bank facilities to patients in need across the state. This process is the first of its kind worldwide.


The development and processes of the NSW Ambulance Retrieval Transfusion Protocol will be discussed and demonstrated with the presentation of specific case studies. A clinical overview of the approximately 100 patients who have received extended blood product transfusion with NSW Ambulance will be presented.


Shand, S., Curtis, K., Dinh, M., & Burns, B. (2018) What is the impact of prehospital blood product administration for patients with catastrophic haemorrhage: an integrative review. Injury.


Sophie is a Clinical Coordinator at NSW Ambulance Aeromedical Operations. This CNS role is responsible for triage, coordination and clinical oversight of aeromedical transfers and medical retrievals throughout NSW/ACT, also providing telephone clinical support.

The position combines Sophie’s previous experiences in UK Critical Care and Emergency Nursing and as a Paramedic with London Ambulance Service before her search for warmer climates brought her to Australia in 2013.

Sophie has completed a BN(Hons) Nursing, FdSc Paramedic Sciences and GradCert Emergency and is currently undertaking post-graduate research studies with the University of Sydney relating to pre-hospital blood transfusion in NSW.