If you build it, they will come - Implementation of a prehospital whole blood program

R B Fransman; C H Meyer; J Nguyen; S R Todd; E R Benjamin; L de Leon Castro; S Collins; L Pack; A Schwartz; B Spaeth; M Thorton; M S McCain; J Sikora; L Kumar

doi:10.1016/j.amjsurg.2025.116587

If you build it, they will come - Implementation of a prehospital whole blood program

Am J Surg. 2025 Dec:250:116587. doi: 10.1016/j.amjsurg.2025.116587. Epub 2025 Aug 21.

Authors

R B Fransman¹, C H Meyer², J Nguyen³, S R Todd⁴, E R Benjamin⁵, L de Leon Castro⁶, S Collins⁷, L Pack⁸, A Schwartz⁹, B Spaeth¹⁰, M Thorton¹¹, M S McCain¹², J Sikora¹³, L Kumar¹⁴

Affiliations

¹ Emory University School of Medicine, USA; Grady Health System, USA. Electronic address: Ryan.brad.fransman@emory.edu.
² Emory University School of Medicine, USA; Grady Health System, USA. Electronic address: courtney.meyer@emory.edu.
³ Grady Health System, USA; Morehouse University School of Medicine, USA. Electronic address: jnguyen@msm.edu.
⁴ Grady Health System, USA. Electronic address: srtodd@gmh.edu.
⁵ Emory University School of Medicine, USA; Grady Health System, USA. Electronic address: elizabeth.robinson.benjamin@emory.edu.
⁶ Grady Health System, USA. Electronic address: ladeleoncast@gmh.edu.
⁷ Grady Health System, USA. Electronic address: scollins@gmh.edu.
⁸ Grady Health System, USA. Electronic address: lapack@gmh.edu.
⁹ Emory University School of Medicine, USA. Electronic address: allison.j.schwartz@emory.edu.
¹⁰ Augusta University/University of Georgia Medical Partnership, USA. Electronic address: BSPAETH@augusta.edu.
¹¹ Grady Health System, USA. Electronic address: mthornton@gmh.edu.
¹² Grady Health System, USA. Electronic address: mmcain@gmh.edu.
¹³ Emory University School of Medicine, USA; Grady Health System, USA. Electronic address: james.sikora@emory.edu.
¹⁴ Emory University School of Medicine, USA; Grady Health System, USA. Electronic address: lekshmi.kumar@emory.edu.

PMID: 40913849
DOI: 10.1016/j.amjsurg.2025.116587

Abstract

Introduction: We sought to develop, implement and evaluate an urban prehospital whole blood (PH-WB) program.

Methods: Using retrospective heat map data, Quick Response Vehicles (QRVs) carrying PH-WB were strategically placed throughout the city and dispatched using dynamic deployment. Patient inclusion criteria were age ≥15 years, traumatic mechanism, and SBP ≤90 mmHg. Prospective data were collected between 3/21-6/21/2025.

Results: 375 patients were transfused 588 units of PH-WB, with 55 % receiving >1 unit. With transfusion, the average SBP increased by 28 mmHg and pulse decreased by 19 bpm from field to ED arrival. The overall survival at 24-h and 30-days was 83 % and 80.8 %, respectively.

Conclusion: This study demonstrates the successful implementation of large-scale PH-WB program utilizing creative strategies to cover a large catchment zone with limited resources. Preliminary results document safe delivery of PH-WB, minimal variation in pre-hospital scene times, 0 % expiration rate of whole-blood in the field and high compliance with protocols.

Keywords: Hemorrhagic shock; Prehospital blood; Resuscitation; Trauma.

MeSH terms

Adult
Aged
Blood Transfusion* / methods
Blood Transfusion* / statistics & numerical data
Emergency Medical Services* / methods
Emergency Medical Services* / organization & administration
Female
Humans
Male
Middle Aged
Retrospective Studies
Young Adult