How we built a hospital-based community whole blood program.

Area of Science:

• Emergency Medicine
• Transfusion Medicine
• Trauma Surgery

Background:

• Whole blood (WB) is a valuable resuscitation product for hemorrhagic shock and massive transfusion protocols.
• Limited experience with WB collection and use necessitated a structured approach for implementation.
• Establishing a WB program requires collaboration between blood banks, hospitals, and emergency medical services.

Purpose of the Study:

• To develop and implement a stepwise process for collecting and utilizing whole blood in clinical practice.
• To integrate low-titer group O RhD positive whole blood (LTOWB) into prehospital and in-hospital resuscitation.
• To assess the feasibility, usage patterns, and initial outcomes of a novel WB program.

Main Methods:

• Collaborated with a regional blood provider to collect cold-stored, leukoreduced, low-titer group O WB.
• Partnered with the local Fire Department to integrate LTOWB into prehospital emergency care.
• Developed comprehensive protocols, software for record-keeping, and training for clinicians and paramedics.

Main Results:

• Between June 2019 and December 2021, 2269 units of LTOWB were received, with 2220 units transfused.
• The majority of transfusions (89%) were administered to trauma patients.
• Monthly usage increased significantly, covering all county fire districts and representing approximately 25% of all hospital trauma blood product use.

Conclusions:

• Developing a WB program is complex but can be initiated gradually, incorporating both prehospital and hospital components.
• Successful implementation requires significant investment in planning, protocols, training, and resources.
• The program has the potential to improve patient care, optimize blood bank and nursing efficiency, and reduce healthcare costs.