Prehospital blood program starts

Kirk’s EMS has started carrying blood on ambulances in southwest Oklahoma so crews can transfuse severely bleeding patients before they reach a hospital. (msn.com) The service said April 23 that it built the program with Our Blood Institute, adding blood storage and field transfusion capability to its ambulances. Prehospital transfusion means paramedics can start replacing lost blood at the scene or during transport instead of waiting for the emergency department. (msn.com; ems.gov) The target patient is someone in hemorrhagic shock, the life-threatening collapse that follows major blood loss after trauma, gastrointestinal bleeding, or pregnancy-related emergencies. A 2025 civilian emergency medical services guideline said these programs are meant to get blood to bleeding patients earlier and cut deaths linked to delayed resuscitation. (tsaco.bmj.com; effectivehealthcare.ahrq.gov) For years, many ambulance systems relied first on crystalloid fluids, the salt-water solutions used to raise blood pressure temporarily during transport. Federal emergency medical services guidance now says severe bleeding is the leading cause of preventable death in trauma patients and that giving blood before hospital arrival can save more lives. (effectivehealthcare.ahrq.gov; ems.gov) Starting a blood program is more than putting a cooler in an ambulance. The 2025 guideline says services need physician oversight, training, temperature control, blood-bank coordination, and quality checks to track every unit from donor to patient. (tsaco.bmj.com; pmc.ncbi.nlm.nih.gov) The same guideline says wider use will depend on tighter handoffs when crews reach the hospital, because field transfusions change what trauma teams see on arrival. It also calls for structured communication and updated activation rules so hospitals know a patient may look temporarily better after receiving blood in the ambulance. (pmc.ncbi.nlm.nih.gov; link.springer.com) Programs elsewhere have been building those rules around whole blood, red cells, plasma, calcium replacement, and limits on excess IV fluid. Recent transfusion criteria from the Collaborative for Blood Resuscitation and Acute Care recommend low-titer group O whole blood for traumatic and medical hemorrhagic shock when systems can support it. (cbrac.org; strac.org) Texas has already moved beyond local pilots: the National Conference of State Legislatures reported that the Southwest Texas Regional Advisory Council began a civilian prehospital whole-blood pilot in 2018, and the Texas Legislature later appropriated $10 million for statewide expansion. That makes Kirk’s launch part of a broader push to move trauma transfusion closer to the roadside and farther from the hospital door. (ncsl.org)