The regional whole blood program in San Antonio, TX: A 3-year update on prehospital and in-hospital transfusion practices for traumatic and non-traumatic hemorrhage.

 

Maxwell A Braverman, Allison A Smith, Angelo V Ciaraglia, Jason S Radowsky, Steven G Schauer, Valerie G Sams, Leslie J Greebon, Michael D Shiels, Rachelle Babbitt Jonas, Samantha Ngamsuntikul, Elizabeth Waltman, Eric Epley, Tracee Rose, James A Bynum, Andre P Cap, Brian J Eastridge, Ronald M Stewart, Donald H Jenkins, Susannah E Nicholson; San Antonio Whole Blood Consortium

 

Transfusion. 2022 Aug;62 Suppl 1:S80-S89.

 

 

Abstract

 

Low titer type O Rh-D + whole blood (LTO + WB) has become a first-line resuscitation medium for hemorrhagic shock in many centers around the World. Showing early effectiveness on the battlefield, LTO + WB is used in both the pre-hospital and in-hospital settings for traumatic and non-traumatic hemorrhage resuscitation. Starting in 2018, the San Antonio Whole Blood Collaborative has worked to provide LTO + WB across Southwest Texas, initially in the form of remote damage control resuscitation followed by in-hospital trauma resuscitation. This program has since expanded to include pediatric trauma resuscitation, obstetric hemorrhage, females of childbearing potential, and non-traumatic hemorrhage. The objective of this manuscript is to provide a three-year update on the successes and expansion of this system and outline resuscitation challenges in special populations.