If you build it, they will come - Implementation of a prehospital whole blood program.
American journal of surgery · 2025-08-21 · Implementation & quality improvement
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.