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Published on: November 30, 2015
Implementing a whole blood pilot program in a rural trauma system: A feasibility, utilization, and cost analysis
Fouad Saeg1, Christopher L Berry, Barbara Tubby
1Division of Trauma and Acute Care Surgery, Robert Packer Hospital (F.S., L.L., S.R.C., R.B.); Division of Emergency Medicine, Robert Packer Hospital (C.L.B.); Department of General Surgery, Blood Bank, Guthrie Medical Group Laboratories (B.T.), Sayre, PA.
A pilot program for prehospital low-titer O+ whole blood (LTOWB) in rural trauma systems is feasible and cost-neutral. This approach enhances early resuscitation and minimizes waste through structured processing, supporting wider adoption.
Area of Science:
- Trauma care
- Emergency medicine
- Blood transfusion
Background:
- Hemorrhage is a leading cause of preventable trauma death, especially in rural areas with delayed transport.
- Low-titer O+ whole blood (LTOWB) offers oxygen-carrying and hemostatic benefits for prehospital resuscitation.
- Logistical challenges, waste, and cost hinder LTOWB implementation in rural trauma systems.
Purpose of the Study:
- To evaluate the feasibility and clinical utility of a prehospital LTOWB pilot program.
- To assess the impact of LTOWB on utilization, waste, cost, and availability in a rural Level I trauma center.
Main Methods:
- Prospective, single-center pilot study (April 2023-March 2024) comparing LTOWB to historical component therapy.
- Weekly deployment of LTOWB to Helicopter Emergency Medical Services.
- Unutilized LTOWB converted to packed red blood cells to mitigate waste; data collection on utilization, waste, cost, and availability.
Main Results:
- 55 units of LTOWB deployed; 45.5% used as LTOWB (27.3% prehospital, 18.2% in-hospital), 47.3% processed into packed red blood cells.
- Only 7.2% of units were lost to waste or expiration.
- Average monthly waste cost was comparable to historical component therapy ($1,576.79 vs. $1,493.89, p=0.692); prehospital availability maintained for 84.2% of study days.
Conclusions:
- Prehospital LTOWB programs are feasible and cost-neutral in rural trauma systems.
- Structured processing protocols maximize LTOWB utilization while minimizing waste.
- Findings support expanding whole blood programs for improved early resuscitation in resource-limited settings.
