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Transcript

Valerie Fuller (Intro):

You’re tuned in to the Clayton Connected podcast in Clayton County where the world lands and opportunities take off.

Valerie:

Hello and welcome to the Clayton connected Podcast in Clayton County Georgia where the world lands and opportunities take off. I’m Valerie Fuller communications administrator for the Office of Communications and with me in the Clayton Connected podcast studio today is none other than our wonderful chief, Tim Sweat. He is our fire chief and EMS director. Also with us is Dr. Mark Waterman who is the Chief Medical Officer so welcome both of you.

Chief Tim Sweat:

Thank you so much.

Dr. Waterman:

Thank you.

Valerie:

So happy to have you here in the studio. Today we are talking whole blood delivery which is a provision of care for the citizens and residents of Clayton County, right?

Chief Sweat:

Yes ma’am.

Valerie:

So, tell us about the whole blood program.

Chief Sweat:

So here at Clayton County Fire and EMS of course we obviously provide advanced life support care via the ambulance service, that is part of my organization and through that level of care we launched a program back on October 1st of 2025 which now allows us the ability to give whole blood to patients in the field who meet certain criteria prior to having them arrive at the hospital. And what that has done, it almost in essence, brings the emergency room to the scene. Prior to the whole blood we could give a sodium chloride solution which basically replaces the volume of blood loss in the body. However, nothing replaces it outside of whole blood. While the saline solution would replace the volume; the O2 and the nutrients needed to feed the organs and the cells in the body we simply could not replace. Therefore, oftentimes trying our best, we simply could not do the life-saving efforts that we can do now with whole blood in the field prior to launching this program. So, we’ve seen phenomenal success thus far. In essence like I said it’s almost bringing the emergency room to the scene with us and just further allowing us the opportunity to provide that life-saving care prior to getting them to the appropriate medical facility.

Valerie:

So, we’re talking pre-hospital blood transfusions. How important is that to Clayton County residents or people who are traveling along the highways through Clayton County?

Dr. Mark Waterman:

So, this is a procedure that’s done in about 2% of EMS fire agencies around the country. Been present for the last few years in big cities; Atlanta for the last year and a half, New Orleans the last two or three years, other major cities. So, it’s a new thing. It started back with the U.S. military in Afghanistan and Iraq where they had to treat severe traumatic injuries and they started using whole blood in the field. That took a few years to translate into the EMS world. I practiced as an emergency physician for several decades in the Atlanta area and it was always frustrating to get trauma patients that had what we called the state-of-the-art treatment which did not include blood. And the very first thing or one of the very first things we did was to transfuse blood. So, hemorrhage is still the leading cause of preventable death with trauma patients.

Valerie:

So, I have to ask this question. We talk about those major cities, but we have this capability now here in Clayton County. How outstanding is that?

Dr. Waterman:

It is standard of care to be in the future. In the next 10 years this will be everywhere. We looked at this the last couple of years and we really wanted to get this rolling. We knew that Grady had started this about a year and a half ago. I had trained at Grady so I was in contact with the people that had started the program there and I finally twisted this here gentleman’s arm and said we can do this too. We looked at our numbers and we knew that we would have between 90 and 100 cases a year of patients that would qualify for this, i.e. signs of hemorrhagic shock.

Valerie:

So let me ask you this. This is not for everyone so there are specific qualifications. Can you tell us about the qualifications? What qualifies one person over the other?

Chief Sweat:

As a recipient of?

Valerie:

Yes.

Chief Sweat:

Doc, I’ll let you kind of jump in. So, what we use is a shock index scale and that shock index scale if it falls within a certain range that patient no matter how they present to us is a candidate for whole blood and one thing I’m going to kind of get back off what Dr. Waterman said twisting my arm. Not exactly but I remember telling him that well if we’re going to do it we’re going to hit the ball out of the park. Dr. Waterman spoke about other agencies around us that are doing it but one thing that I am extremely proud of and I know Dr. Waterman is as well. When we launched our program on October 1st of 2025, no matter the age of the patient no matter the presentation of the patient if they are a candidate for whole blood we start that process immediately. What you see around us historically is those agencies that have come on board with a whole blood program are simply only giving it to patients that have a traumatic injury and the majority of that is simply only adults. How we are different from those agencies around us and going back to we, took us almost two years to get this launched but our goal was to launch it across every facet of our emergency response platform. So, no matter if you have a medical issue where you have some type of hemorrhage you qualify for us. If you’re a pediatric patient, a child who unfortunately suffers a traumatic event, we have the ability to provide whole blood. So unlike others there is no we only do this and not that. If the patient in front of us no matter what the circumstances, shock index indicates why we are initiating whole blood in them.

Valerie:

So, tell me about this 90-day roll-up what it’s been a little bit over 90 days right since the program rolled out. What all was involved in that process?

Chief Sweat:

So, prior to the biggest thing and I’ll kind of let Doc kind of get a little bit deeper into this is of course you got to have the whole blood product right?

Valerie:

Right.

Chief Sweat:

Looking at programs around us, a lot of agencies who have launched a whole blood program are not actually giving whole blood. Some of them are giving platelets or a variation thereof. Once again with our program we were going to do it we’re going to do it right. Where we were blessed and fortunate that we have a hospital right here in our community Southern Regional Medical Center who on day one were on board to serve as our blood bank.

Valerie:

So, kudos to Southern Regional Medical Center.

Chief Sweat:

Yes ma’am.

Valerie:

Absolutely.

Chief Sweat:

Of course, we kind of built out the program I had to go through our elected body or board of commissioners and get their blessing to enter into some agreements with Southern Regional for that process. And even a more blessing to them Southern Regional and Miss Elena who serves as their president and chief executive officer came on board on October 1 and has agreed to support the cost of the program from the whole blood perspective for the first 12 months. So, there were some initial infrastructure costs that we were able to get through grants. So, the onboarding of the program the launch of the program has cost the citizens of this county zero tax dollars. We were able to do everything through grants and the generous donation of the first year being funded by Southern Regional.

Valerie:

And as a result of that definitely saving some lives.

Chief Sweat:

We have saved lives. Yes ma’am.

Valerie:

So how do you plan to expand the program moving forward?

Dr. Waterman:

So just to piggyback off of his last comments and in addition, the training that went on took about six weeks so we decided to train all the paramedics in our organization, about a hundred and fifteen paramedics. That was the key step. So we selected one of our training senior training officers and that was about an eight out, eight to ten hour training day they spent. So, each of them were prepared to do this and we decided talked amongst ourselves about the best way to deploy the blood and put it in two of our supervisor to vehicles so that blood goes to the scene it’s dispatched with that senior officer when that all comes into 9-1-1.

Valerie:

So really good information so excited to have you guys here I can’t wait to bring you back to find out more information about how successful this program has been and what it has meant to people who actually are qualified for the program and actually receiving this service. So can’t thank you enough for what you do and what you’ve done in reference to bringing this program to Clayton County. So, what does the expansion of the program look like next?

Chief Sweat:

Yeah so, the first 90 days once we get the initial 90s on board we extracted the data started to dissect it and in the first 90 days October 1st 2025 to December 31st we had a total of 21 cases that were candidates of an whole blood transfusion which resulted in the delivery of 28 units of blood. So what that tells me is seven of those 21 patients we gave two units of blood while en route to the hospital. The breakdown on that 43% of our cases were an individual who is struck by an auto. 38 of those cases were medical; i.e. some form of GI bleed, once again, going back to we do medical and trauma. 14% of those were via gunshot wounds and the remaining 5% were motor vehicle accidents. We are averaging giving blood every four days in our organization and 17 of those 21 initial cases had a pulse upon being turned over to an ER physician at a trauma facility and or our local hospital, which looking at some of those without whole blood would have not have had that outcome. What the initial 90 days has shown us is the way we are currently working the program, I have two supervisors who carry the whole blood itself and the infrastructure it takes to administer the blood into the body. The majority of our cases are coming in north of highway 138 in the county so I have a north end supervisor who has whole blood who runs out of station 1 which is adjacent to Southern Regional Hospital. I have a south end supervisor who carries whole blood who runs out of our station number 12 down off Mundy’s Mill Road. Initial data in the first 90 days is showing us that the expansion to a second supervisor unit north of 138 is in the foreseeable future. It is our goal that through our dispatch algorithms and working with our 9-1-1 center through our Clayton County Police Department, we’ve built certain algorithms as calls come into our 9-1-1 center and they hit certain benchmarks when that call is dispatched one of my supervisors is also dispatched along with those first in units. It’s our goal to get that whole blood to the scene to those paramedics that are on those ambulances so that we can get it administered to the patient as quick as possible so it’s looking like we will expand to a third unit. The beauty of that is when we bought all the infrastructure to stand up, we initially bought infrastructure to support three units. So once we do expand to a third, once again, there’s no cost. We have a lot of infrastructure in place. It’s simply taking that and putting it on a third unit, which will help us even more have the ability to get that product expedited to the scene as soon as it is needed through the initial assessment from those medics. Once again, that shock index score it’s a thumbs up; yes they’re a candidate let’s roll or thumbs down, no they do not meet. We further our other care and get them to the closest facility.

Valerie:

So, we have the whole blood delivery. We have coverage based on the statistics and you’re continuously looking at those. You’ve set your goals and we’ll move them as you see fit. What is it that residents or citizens can do to help?

Chief Sweat:

Give blood. I know here in Clayton I have a blood drive within my organization, just had mine a few weeks ago. Our lovely police chief, Kevin Roberts and his organization also does a blood drive within the county and I’m sure there’s other blood drives throughout. So once again, the way we are able to provide this life-saving measure in the field is by individuals in our community so graciously donating at those blood drives because once you donate it goes to the system and it goes into the facilities we’re at wherever and when needed that is the blood that helps us save lives in the field so at the end of the day to support any and all blood drives you can. Doc correct me if I’m wrong I think when you give you have to wait 50 days where you can give again 45 or 50 something like that, but just how you can support us is donate blood please.

Valerie:

Dr. Waterman?

Dr. Waterman:

So the other thing is, to understand the change that this brings to the community so the numbers are, when you really delve into the numbers, so we’re taking mortality rates that would be 50% for penetrating blunt trauma, motor vehicle accidents, pedestrians hit by vehicle and reducing that mortality rate of about 50% down to the low teens. In other words a three and a half fold improvement in your likelihood of getting out of the hospital.

Valerie:

Wow.

Dr. Waterman:

That is huge.

Valerie:

Yes.

Dr. Waterman:

I wish I could share some of the individual stories of patients that we’ve encountered over the last several months. There are patients that I can guarantee you would not have made it to the hospital let alone out of the hospital. We have young individuals with their whole life in front of them who are able to get out of the hospital and lead productive lives. If you just save one life that’s great but when you start talking about scores of patients in the community that word gets out or I hope it does get out, and that’s why one of the reasons why we’re here. This is a huge deal.

Valerie:

Absolutely.

Dr. Waterman:

There are 29 counties now in Georgia that are wanting to participate in whole blood so it’s still a few counties. We’re lucky enough to have an agency that’s very innovative. This is one of the most innovative things that have that has happened in EMS in the United States.

Valerie:

Right, and it’s happening right here in Clayton County. So where can we find more information on the whole blood delivery program and where can people follow you on? Facebook?

Chief Sweat:

Yeah, so Facebook we’re very active on social media. So Facebook Clayton County Fire and Emergency Services. Please spell out Clayton County Fire and Emergency Services and to a guest, the official site that is the same log in as well our username for our Instagram page. More information follow us on social media follow us on through our website at ccfes.org where a lot of our social media pushes to our front page of our website so therefore if you’re not a social media individual and you still want to read you can go to our website and see some of that but just stay tuned follow us as we expand the program. As Doc said it’s my hopes that we can share some success stories in the future. There is a particular case that took place up in District 1 in the northeast of the county with a young man that I hope to eventually have him share his story because as Doc said we have followed him since his incident and there is no doubt that without this program in our community he would not be with us today.

Valerie:

Well we are looking forward to hearing more from some of the people who have definitely benefited from that so we welcome them on the Clayton connected Podcast with you to help share and tell that story. And you can also, I want to encourage our citizens to sign up for the newsletters because all of the information, activities, events and news that’s happening with the Clayton County Fire Department and Emergency Services is posted in the newsletters also and you can also follow us on claytoncountyga.gov. So, on behalf of our Fire Chief and EMS Director, Mr. Tim Sweat, Chief Tim Sweat thank you for coming. Dr. Mark Waterman our Chief Medical Officer thank you for coming and we’ll welcome you back to the next Clayton connected Podcast.

Chief Sweat:

Thank you so much.

Valerie (outro):

I’m your hostess Valerie Fuller thank you for listening to the Clayton connected Podcast in Clayton County Georgia where the world lands and opportunities take off!