A Paramedic's Perspective on Prehospital Blood Transfusions

Eric Hudspeth, PA-C, EMT-P, knew he wanted to be a paramedic the day an accident victim died in his arms.

On the day Hudspeth witnessed a horrific motor vehicle accident, he was driving home from work in Phoenix, Arizona when a BMW flew by him in a 35 mph zone. The driver subsequently lost control of his car, swerved into oncoming traffic, ramped off of a Lincoln Town Car, went airborne, and struck a pedestrian on the other side of the road.

Hudspeth, who at that point had no medical training, didn’t know what to do.

“I was the first person at the scene,” he says. “I opened the doors of the Lincoln Town Car and saw everyone on the floorboard. I thought they were all dead. Thankfully, they were just unconscious.”

Hudspeth then sought out the pedestrian who got hit, finding him in a ditch 50 yards from the scene, barely breathing.

“He was hit so hard his clothes got knocked off of him,” he says. “I remember when the ambulance got to the scene there was this wave of calmness and a feeling like everything's okay – now the ambulance is here.”

The man would die in Hudspeth’s arms.

“It got me thinking about EMS and what they did,” Hudspeth says. “It was attractive to me because I'm a bit of an adrenaline junkie. My family had been in medicine for quite some time. I didn’t think I wanted to do that. But I really found the calling and that day, I made a promise to myself that if I were to experience something like that again, I would at least have the basic training of knowing what to do. That’s what steered me into EMS.”

Hudspeth’s Accident & the Road to EMS

Hudspeth became an EMT, then started working for Medic (Mecklenburg EMS Agency) from 2014 to 2016. After earning his paramedic certification, He served the agency from Dec. 2016 to April 2020.

In June 2014, Hudspeth was riding a motorcycle with a friend who was a paramedic when a drunk driver crossed the center lane.

“There was nowhere for me to go,” he recalls. “I had to lay my bike down and she hit me head-on going at a pretty fast rate of speed. I rolled over her hood.”

There was an EMS base about five minutes away from the scene of the accident and 10 minutes away via ambulance to the nearest trauma center.

“My co-workers scraped me off of the pavement, got me into the back of the ambulance, and started the lifesaving process,” Hudspeth says. “The only thing I remember about that interaction is getting my chest decompressed with a needle and being able to take a big deep breath. I got resuscitated in the trauma bay and taken to surgery.”

Hudspeth says he learned much from the incident, “but one of the most important things is that I can empathize with my patients. I know what it feels like to be a patient. I know what it sounds like, what it looks like to be a patient. I think having that approach makes me a little bit more relatable to patients.”

The Role of Blood Donors

The experience also made Hudspeth – who, over time, has been a spokesperson for OneBlood – more aware of the key role blood donors play in the healthcare system.

“I had significant internal bleeding that had to be stopped by a surgeon in the operating room,” Hudspeth points out.

According to OneBlood, Hudspeth had received 36 units of red blood cells, 35 units of plasma, and two units of platelets as they worked to stabilize his battered body within the first 24 hours of his injury.

Hudspeth underwent 25 subsequent operations with most requiring blood transfusions. In addition to receiving blood through the regular route, Medic – where Hudspeth had worked – conducted a blood drive on his behalf.

Hudspeth – whose blood is O positive – says he’s aware the number of units of blood he received represents many people’s donations.

“I was afforded a really amazing opportunity with OneBlood,” he says. “I gave them permission to go through my electronic medical record and they backtracked all of the people who donated the blood that I received. I was able to meet them in person.

“It was a really special situation. I don't think that happens often. It was just as impactful for me as it was for them, I think.”

Hudspeth says he wants people to recognize that a blood donation really does make an impact.

“It’s not something that can be created in a lab,” he points out. “There’s no alternative to blood. It’s that thing that if you need it, you got to have that one specific thing. It was special to meet those people and communicate my gratitude to them.

“They collectively gave me a second shot at life and I’m not going to squander it. I told them what my aspirations were.”

Hudspeth’s Impact on EMS

Hudspeth has made a significant impact in the field, holding licenses and certifications that include ACLS provider, BLS provider, and PALS provider from the American Heart Association; Advanced Trauma Life Support from the American College of Surgeons; Paramedic from NCOEMS, and Prehospital Trauma Life Support from the National Association of Emergency Medical Technicians.

Hudspeth earned a B.S. degree in emergency medicine from Western Carolina University in 2019.

“I knew from having physicians in the family that I did not want to be a physician,” Hudspeth says. “It was not an attractive lifestyle to me, not something I wanted to do. I knew that I loved medicine. Early on, I had the taste for more skills, more knowledge. I made it a goal to become a PA. I was familiar with how physician assistants operated and the emergency department through my work in EMS.”

With his goal set in mind, in May 2022, Hudspeth earned a Master of Medical Science, Physician Assistant from Wake Forest University School of Medicine.

Hudspeth subsequently was accepted into a year-long emergency medicine fellowship at Atrium Health Carolinas Medical Center in Charlotte, North Carolina where he got more training and broadened his skill set. He went on to work for Atrium Health Cabarrus in Concord, North Carolina as an emergency medicine physician assistant as well as Atrium Health in Charlotte, North Carolina.

Hudspeth has broadened his impact to other endeavors as well, both paid and volunteer work.

In May 2022, Hudspeth became involved as a contracted medical instructor with the Global Surgical and Medical Support Group (GSMSG) in Honduras where a military unit was doing counter-narcotics operations and required medical training.

“We trained them in military medicine and tactical combat casualty care, which has a big emphasis on hemorrhage control and the basics of trauma resuscitation,” Hudspeth says.

“GSMSG is a phenomenal group of individuals,” he adds. “They're primarily special operations, active duty, or retired individuals. They're adjacent to the battlefields that are happening throughout the world – they are in the Ukraine and Israel right now. Their primary mission is to be an adjunct help in training the local population and assisting with their skill set whenever they need it.”

From August 2018 to September 2022, Hudspeth served as a paramedic instructor at the Carolinas College of Health Sciences.

Hudspeth has volunteered for OneBlood and as a clinician for Paramedics for Children, an international nonprofit organization providing medical care, education services, and disaster response.

Making Pre-Hospital Blood Transfusions the Standard

Hudspeth says it should be standard in every U.S. ambulance to increase advocacy for pre-hospital blood transfusion in an ambulance.

“Blood has been in EMS for a long time,” he notes. “It’s been on helicopter EMS. One of the constraints of administering blood products is that you don't have a place to store it. The other problem is procuring it. There needs to be a blood bank that's willing to let their blood be used. If you solve those two issues, I don’t see why every single ambulance in the country can’t have blood.”

Hudspeth encourages EMS providers to be cognizant of the importance of having access to blood locally and offering information on how to donate blood to attract more donors.

“You can donate every eight weeks,” he adds.

Another factor he points out is learning on to save blood by knowing how to save it in the body.

“That’s about hemorrhage control and being able to keep red blood cells in people's body so they hopefully don't need as many blood transfusions as I did,” he says. “The general public should be educated on how to properly apply a tourniquet and put pressure on a wound that's bleeding.

“I see the importance of blood transfusions on a daily basis when I step into work,” says Hudspeth. “I administer blood to patients now that need it and there are times where blood supplies are at a critical low point. If we could get people to donate more blood, it would be such an amazing thing for the community and the patients who need it.”