SWIFT Trial Results Published in Prestigious Medical Journal

The results of the SWIFT (Study of Whole blood In Frontline Trauma) trial have been published in the New England Journal of Medicine (NEJM), providing evidence on whole blood transfusions in pre-hospital care.

The NHS Blood and Transplant-led trial, which launched in 2022, investigated the use of whole blood transfusions in frontline trauma care — an area of vital importance to teams like ours at Essex & Herts Air Ambulance. Blood transfusions are a critical tool in pre-hospital care: when someone is severely injured, our critical care teams are able to provide a blood transfusion directly on scene.

EHAAT was proud to be one of 10 UK air ambulance charities that contributed to this major multi-centre study, in partnership with the Ministry of Defence and Air Ambulances UK, providing a significant volume of data to help advance understanding in this field. The study analysed 616 trauma patients — 314 receiving whole blood and 302 receiving standard care — to explore whether giving whole blood on scene could improve survival and reduce the need for further transfusions once in hospital.

What did the study find?

The findings did not demonstrate a benefit of one type of blood product over another, suggesting that either could be used, and will help inform future NHS guidance, procurement decisions, and research priorities across the pre-hospital medicine sector.

Whole blood transfusion has recently gained favour in trauma care, but data from large clinical trials has been lacking, until now. It is of particular interest to air ambulance teams because it is easier to transport and transfuse a single product than several, and platelets are difficult to store and transfuse separately.

Critically, the study also reinforces the importance of ensuring critical care teams can administer emergency blood transfusions to patients who are bleeding significantly as a result of serious injury. We carry blood products on our helicopters and rapid response vehicles, in partnership with NHS Blood and Transplant and Princess Alexandra Hospital, Harlow.

Laurie Phillipson, SWIFT Principal Investigator and Clinical Academic Fellow, said:

“This trial represented one of the biggest research collaborations across multiple air ambulance teams to date. We are very proud to have been involved, providing a significant amount of data and helping to extend the boundaries of pre-hospital medical knowledge. The results of this study will help us understand which blood products are optimal for resuscitating patients that suffer serious trauma in traffic collisions, accidents and falls. Just as important, it will help us understand where we need to direct future research.”

Dr Tony Joy, Medical Director, added:

“We are pleased to see the results of the SWIFT trial released in the New England Journal of Medicine, an important study that Essex & Herts Air Ambulance collaborated in alongside many other air ambulances across the UK. The research processes required to undertake major multi-centre studies of this nature are a strong reflection of the collective desire across the air ambulance community to embed academic study in our services, and ensure we are committed to improving outcomes for our patients of the future.

Whilst this study has not shown a benefit of one type of blood product compared to another, we are clear that it remains vitally important that our critical care teams are able to provide an emergency blood transfusion to our patients if they are bleeding significantly as a consequence of their critical injury.

Professor Laura Green, co-chief investigator for SWIFT and Associate Medical Director for Research and Development at NHS Blood and Transplant, said:

“The contribution of everyone involved in delivering the trial will help guide the future care of people experiencing traumatic, life-threatening bleeds. The trial did not show a benefit from whole blood but in providing that answer it will help us improve trauma care. We are extremely grateful to the blood donors, patients, and everyone involved in delivering the trial — including the manufacturing team at NHS Blood and Transplant, air ambulance organisations, hospital teams, academic institutions, and the Defence Medical Services — for working together to drive innovation and research that benefits seriously ill patients.”