Implementation of a prehospital whole blood program: Lessons learned

Area of Science:

• Emergency Medicine
• Trauma Resuscitation
• Blood Transfusion Services

Background:

• Hemorrhagic shock requires timely intervention to prevent organ damage.
• Prehospital blood programs offer critical resuscitation capabilities.
• Successful programs necessitate careful planning, safeguards, training, and resource management.

Purpose of the Study:

• To describe the operational experience of Maryland's first prehospital ground-based low-titer O-positive whole blood program.
• To share lessons learned for establishing and managing similar prehospital blood transfusion initiatives.
• To inform other EMS systems on best practices for prehospital blood administration.

Main Methods:

• Implementation of a prehospital blood program based on a four-pillar model (Yazer et al., 2022).
• Focus on product rationale, storage and transport, transfusion criteria and personnel, and documentation.
• Operational experience and lessons learned from Maryland's program.

Main Results:

• Successful establishment and operation of Maryland's inaugural prehospital ground-based low-titer O-positive whole blood program.
• Demonstrated feasibility of implementing prehospital blood transfusion protocols.
• Identified key factors for successful program implementation and resource stewardship.

Conclusions:

• Prehospital blood programs are vital for improving outcomes in patients with hemorrhagic shock.
• Adherence to established best practices is crucial for program success.
• The Maryland experience provides a valuable model for other EMS systems developing prehospital blood programs.