Storage Age of RBCs Transfused by a Prehospital Patient Transport Program vs the Hospital Emergency Department

Recently published data suggest that transfusion of RBCs stored for 22 days or longer was associated with increased mortality among massively transfused trauma patients.

We performed a 24-month retrospective review of medical transport service transfusion records and a 2-month, overlapping review of transfusions of uncrossmatched RBCs in the emergency department.

RBC units issued to the transport program were older than RBC units issued to the emergency department trauma refrigerator (10.6 vs 8.7 days, P < .001). Similarly, RBC units were older at the time of transfusion during transport compared with the emergency department (20.3 vs 14.3 days, P < .001).

Transport programs and blood banks should jointly review their RBC inventory management programs. Issuing RBCs to a medical transport program is a logistical challenge that, unless actively managed, may not ensure access to blood that is as fresh as blood in the emergency department.