In this episode of EMS One-Stop, host Rob Lawrence is joined by Dr. Christine Carico and Dr. Matt Levy to discuss the peer-reviewed paper, The paper, published in 鈥淭ransfusion鈥� in April 2025, explores the use of blood products in prehospital trauma care.
Despite the proven benefits of blood transfusion in the field, their research uncovers the alarming reality that less than 1% of eligible patients receive prehospital blood products. This conversation dives into the study鈥檚 methodology, key findings and the significant barriers EMS systems face in implementing blood transfusion protocols. The discussion also touches on the evolving role of EMS in trauma care, regional variations in blood product access, and the future of prehospital blood transfusion programs.
Dr. Carico and Dr. Levy break down their work and reflect on the data, explaining how the study used National Emergency Medical Services Information System (NEMSIS) data to identify trauma patients who would have benefited from blood transfusions.
The episode delves into the operational challenges EMS systems face in obtaining and administering blood products in the field, the financial and logistical obstacles, and the potential life-saving impact of more widespread adoption of these protocols.
Memorable quotes
- 鈥淚n our study, we identified 1.2 million patients who were potentially eligible for prehospital blood products, but less than 1% actually received them.鈥� 鈥� Dr. Christine Carico
- 鈥淭he biggest single barrier has been getting access to blood. It鈥檚 one of the most precious commodities we deal with, and overcoming that barrier is key.鈥� 鈥� Dr. Matt Levy
- 鈥淓MS is at the tip of the spear of the acute care health system, and our role in the delivery of prehospital blood products is a critical part of that care.鈥� 鈥� Dr. Matt Levy
- 鈥淲hile the study focused on trauma, the evidence is clear: early blood transfusions can benefit medical patients as well, particularly those suffering from hemorrhagic conditions.鈥� 鈥� Dr. Matt Levy
- 鈥淭he data we have shows that prehospital blood programs are not just life-saving for trauma patients, but they could benefit a larger number of patients if we expand the criteria for blood product use.鈥� 鈥� Dr. Christine Carico
- 鈥淎t the end of the day, EMS is about logistics, and if we can master the logistical side of things, implementing blood transfusion protocols will be much more feasible.鈥� 鈥� Rob Lawrence
Timeline
- 00:00 鈥� Intro and welcome: Rob Lawrence introduces Dr. Matt Levy and Dr. Christine Carico, setting up the discussion on prehospital blood product use
- 03:00 鈥� Study overview: Dr. Carico explains the methodology of the study, focusing on the use of NEMSIS data and the inclusion criteria for the patient population
- 07:00 鈥� Key findings: Dr. Carico reveals the key findings of the paper, including the low percentage of eligible patients receiving prehospital blood products
- 11:00 鈥� Barriers to implementation: Dr. Levy discusses the main barriers to the widespread implementation of blood transfusion protocols in the field, including access to blood, logistics and training
- 17:00 鈥� Regional variations: The speakers touch on the regional disparities in blood product availability and the differences in protocols across the country
- 23:00 鈥� Data challenges: Dr. Levy and Dr. Carico discuss the challenges related to data accuracy, particularly in terms of blood product documentation
- 27:00 鈥� Cost and reimbursement: Dr. Levy addresses the financial aspects of blood product programs, including cost, reimbursement challenges and funding opportunities
- 32:00 鈥� The future of blood transfusion in EMS: Dr. Levy envisions the future of prehospital blood transfusion programs, including the potential for shelf-stable blood products and regional blood supply systems
- 37:00 鈥� Closing thoughts: Both guests offer their final thoughts on the importance of continued research and data collection, and the need for EMS to embrace a more integrated role in acute care
Additional whole blood resources:
- Tracking the whole blood landscape as updated guidelines allow EMS to carry and administer whole blood
- EMS One-Stop: Stop the bleed, fill the tank 鈥� The New Orleans EMS blood program
- Insider analysis: Delaware鈥檚 statewide whole blood rollout sets a new EMS standard
- Whole blood in EMS promises a revolution in resuscitation: How one county agency is saving lives with prehospital transfusions
