Quick Facts

• Only 2-3% of U.S. ambulance services carry blood, but programs are expanding rapidly nationwide
• Studies show patients receiving blood before hospital arrival have four times better survival rates
• More than 60,000 Americans bleed to death annually from trauma, with 10,000 lives potentially savable through pre-hospital transfusions

More ambulance services across the United States are equipping vehicles with blood products for emergency transfusions. The expansion comes after research showed dramatic improvements in trauma survival rates.

Of the more than 11,000 EMS agencies providing ground transport to hospitals, only about 2-3% currently carry blood. But medical experts report a 30% increase in pre-hospital blood programs in recent months.

“This is one of the only things that EMS can do that is truly lifesaving,” said Interim Chief Matthew Karpinski of the Ozaukee Central Fire Department.

Research demonstrates the critical importance of rapid blood delivery. One trial of nearly 1,400 trauma patients found those receiving whole blood had four times better survival rates. Military studies showed soldiers who received blood within minutes of injury were four times more likely to survive.

The National Highway Traffic Safety Administration found every minute without blood increases death risk by 11% for trauma patients. With prompt pre-hospital blood delivery, researchers estimate 37% of severe bleeding patients could be saved.

San Antonio’s Brothers in Arms program has administered 1,395 pre-hospital transfusions since October 2018, doubling lives saved. Boston’s Field Transfusion Paramedic Program serves 30 towns and has responded to more than 40 calls since launching last March.

“I don’t think that people understand that ambulances don’t carry blood,” said Jeffrey Kerby, chair of the American College of Surgeons Committee on Trauma. “They just assume they have it.”

More than 60,000 Americans die annually from traumatic bleeding caused by car crashes, gunshot wounds, pregnancy complications, or gastrointestinal hemorrhaging. The American College of Surgeons estimates 10,000 lives could be saved yearly with expanded pre-hospital blood programs.

Recent program launches include Mercyhealth’s MD-1 Emergency Response Program in Rockford and Burnsville Fire in Minnesota, the first department in the state to carry low-titer O-positive whole blood.

The Centers for Medicare and Medicaid Services plans to modify reimbursement definitions to include pre-hospital blood transfusion therapy. Currently, insufficient payments from Medicare, Medicaid, and private insurers create barriers, with blood units costing more than half the Medicare reimbursement for the highest EMS care level.

EMS services typically carry low-titer O whole blood, safe for any patient, or blood components including liquid plasma and packed red blood cells. In 2023, America’s Blood Centers supplied over 32,000 blood products to emergency management systems supporting pre-hospital programs.

Read more: More ambulances are carrying blood for transfusions. Experts say it will save lives