By Liese Klein
The Hour
HARTFORD, Conn. — Military medics learned a life-saving lesson in recent wars: Patients suffering from severe bleeding did better when treated with “whole blood,” not the plasma and other blood products used in the field in past decades.
Now first responders supplied by the Trinity Health of New England network are applying that lesson at car crashes and other emergencies in Connecticut thanks to an expanded whole blood program led by doctors with military training.
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“The patient is bleeding whole blood — we’re going to give them whole blood back,” said Dr. Wesley Kyle , an emergency physician and EMS medical director at Saint Mary’s Hospital in Waterbury. Kyle, a retired Army major, brings to the whole blood program his training as a combat physician.
“Whole” blood, or blood in its natural state, fell out of regular use in medical care over the decades as technology allowed it to be broken down into specialized components like plasma, platelets and red blood cells. Most blood donated through the Red Cross now goes toward those components, Kyle said.
But medics on the front line in the wars in Iraq and Afghanistan started going back to whole blood due to the fact that it took too much time to put individual blood components together to meet a patient’s needs in the battlefield. Patients also seemed to respond better when treated with whole blood, Kyle said.
In civilian life, whole blood is especially effective in treating severe bleeding the chest and abdomen caused by car and other accidents, falls, gunshot wounds and childbirth injuries.
Recent medical advancements that allow whole blood to be transfused directly into injured parts of the body like the chest and abdomen add to the treatment’s effectiveness, Kyle said.
“There has never been an intervention, perhaps, in the history of emergency medicine, that has the potential to reduce mortality as much as putting blood out to the point of injury,” Kyle said.
Advances in storage and monitoring allowed for the use of whole blood even in battlefield scenarios, Kyle said.
“The military was the first to do that, to realize that this is really logistically simple,” Kyle said. “We realize that there’s a tremendous advantage, logistically and from a resuscitative point of view, to keep that product in its whole form.”
Military lessons migrate to civilian treatment
The use of whole blood is just the latest innovation to move from the battlefield to local ambulances, said Dr. John Pettini, chief of EMS at Trinity Health of New England and EMS medical director at Saint Francis Hospital in Hartford.
Tourniquets, dismissed for decades as a potentially risky treatment, are back in ambulances and police cars in 2026 thanks to data gathered in recent wars that proved the devices’ superiority in treating severe wounds in the arms and legs.
“Tourniquets had gone by the wayside,” Pettini said. “Now, I defy you to find a police officer that doesn’t have one or is trained... in an airport or synagogue or anywhere there’s the potential for mass casualty.”
With whole blood, keeping ambulances stocked is actually simpler than supplying and reconstituting individual blood products, Kyle said. The blood is kept in cold storage in the vehicle and is regularly refreshed with new supplies from the hospital.
In partnership with three local ambulance services, Saint Francis supplies whole blood to first responders for use at accident scenes.
At Saint Mary’s, a small refrigerator in the trauma bay stores whole blood for use by two ambulance services, Kyle said. The hospital is the only facility in New Haven County supplying whole blood to first responders.
Like all blood products, whole blood undergoes strict screening and safety protocols to ensure it is free of any pathogens or contaminants.
Trinity was an early adopter of supplying whole blood to EMS systems and won a Department of Transportation grant in October to help expand the program regionally, Pettini said.
Seeking to cut car-crash deaths, the government is seeking more data on the use of whole blood by first responders ahead of encouraging nationwide adoption. Expanding the use of whole blood could save 10,000 lives a year, according to a report by the American College of Surgeons .
Using techniques used in battle to save lives at home is one upside of conflicts that result in so much loss, Pettini said.
“When we started the blood program here at St Francis, the only thing we had to lean on was the military experience,” Pettini said. “Sometimes it takes a while to translate lessons learned into civilian practice.”
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