Hemodynamics, fluids & transfusion
Characteristics, Regional Evaluation, and D-Antigen in Transfusions by Emergency Medical Services
Authors' conclusion
This cohort study of civilian PHT practices in the US found geographic and temporal variability. There was increasing adoption of WB and significant implications for females of childbearing potential who are increasingly likely to receive D-positive PHT. Cases of PHT uncommonly involved short prehospital duration.
Study context
- Population
- Trauma and nontrauma patients of all ages receiving prehospital-initiated transfusion by emergency medical services (EMS) in 48 US states, January 2020–October 202418,177 units transfused
- Participants
- 10,444 participants
- Outcome
- Age, sex, blood product characteristics (incl. blood type) and transport time
Methodological detailsnationwide, 48 US states
- Nationwide
- 48 US states
Main finding
As reported in the abstract
- Proportion of transfused units that were whole blood (WB), 2020 to 2024 (P < .001)
- 10.0% to 30.8%
- Northeast highest proportion of WB use (of prehospital transfusion (PHT))
- 33.2%
- Females of childbearing potential (aged 12-50 years), 95% CI 14.5%-15.9%
- 1589 (15.2%)
- Females of childbearing potential receiving D-positive blood products, 2020 to 2024 (P < .001)
- 73 of 169 [43.2%] to 372 of 497 [74.9%]
- Prehospital times 20 minutes or less, 95% CI 2.2%-2.8%
- 255 of 10 343 (2.5%)
Observational data: associations, not effects.
Original publication
Characteristics, Regional Evaluation, and D-Antigen in Transfusions by Emergency Medical Services. JAMA Netw Open. Published 1 July 2025. doi:10.
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