Life saving operational requirement driven forward by TA officer Colonel Heidi Doughty
Nominated category: Healthcare Reservist of the Year
Seriously injured soldiers are at risk of bleeding to death due to physical disruption of blood vessels. The problem is due to the low levels of plasma clotting factors and platelets. Platelets are vital for normal clotting and whilst they can be donated in the UK they only last for 5 days in special storage conditions. Delivering platelets to the battlefield from the UK is an enormous logistic challenge - it is almost a ‘mission impossible’. The UK is the only nation providing platelets from their blood service and sometimes cannot get the platelets there. A new solution was required – Operational apheresis. This has allowed soldiers to help other soldiers by giving life saving platelets.
Col Doughty had already been closely supporting the Blood Supply Team since 2005 when the military team moved to Birmingham. Col Doughty then volunteered as a TA officer working for the National Blood service to drive forward this Urgent Operational Requirement in Nov 2007 as the medical officer.
Col Doughty is an employee of NHS Blood & Transplant (NHSBT). The organisation has been key to the success of this project. Line managers have granted her unpaid leave and flexible working hours in order to respond at often short notice. The NHSBT has continued to work closely in the provision of advice and highlighting the importance of the work through staff and donor communication. Col Doughty has used the project in the education and recruitment of platelets donors for the NHS. In addition, she has lectured to a wide range of groups highlighting the need for blood and platelet donation to support civilian trauma. Col Doughty has worked closely throughout with the military blood supply team, part of Medical & General Supplies IPT and the Defence Consultant Advisor in Transfusion. The project also supports soldier donors by allowing them to give platelets and return immediately to duties. Donors can give regularly every month unlike whole blood donors who can only give once every few months. Donors have an enormous sense of satisfaction. In addition, she has excellent support from 2 Medical Brigade and her own TA Unit.
The project is a unique example of a small but successful project that has made a real difference in a short space of time with relatively small financial outlay. The UK is the only nation that provides fresh platelets from a home nation. The project has required the purchase of new equipment, new training, concepts of operations and quality systems. Col Doughty has been the only member of the team that has stayed with the project throughout and has done this project alongside Command of a Field Hospital, a busy NHS consultant job and despite ill health. The project has worked because of a few committed individuals who have gone that extra mile.
Operational apheresis has been a complex project that has required working with a number of agencies who have sometimes had to take a leap of faith. The greatest challenge is that of training. Apheresis is now taught as a pre-operational course to nurses and biomedical scientists who have often never seen the process and may have never heard of it. The technique requires the nursing staff to place a relatively large needle safely within a vein. It has been an enormous task to persuade TA and regular nurses to have the confidence that they can perform this technique safely on their colleagues and to be able to do it with a very seriously ill patient waiting for the product. Dr Doughty developed a training programme working with together with the NBS, the commercial company and others. The programme now permits live apheresis to be included in pre-deployment validation exercises.
The operational apheresis programme has demonstrated how TA personnel can bring unique skills to the Defence Medical Services. The programme has also demonstrated the increasingly flexible and integral role that TA healthcare reservists provide which goes beyond the traditional 27 days a year and deployment.