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Fire, EMS, hospital partnership delivers whole blood to Texas trauma patients

Arlington Fire Department, AMR Arlington and Medical City Arlington have launched a Whole Blood Program, allowing paramedics to give transfusions in the field

By Ciara McCarthy
Fort Worth Star-Telegram

ARLINGTON, Texas — Arlington’s first responders can now provide whole blood to trauma victims, a significant upgrade in the standard of care for patients who have suffered blood loss.

Whole blood is blood from a donor that has not been separated into its component parts. Previously, trauma victims in Arlington would receive saline solution in an emergency before they got to the hospital. Now, paramedics can provide mobile blood transfusions en route to the hospital.

| WATCH NOW: Bringing whole blood to the front lines of EMS

“The sooner we get blood started, the better the outcomes for patients, especially those who are experiencing hemorrhagic shock or some type of medical emergency,” said Chris Weinzapfel, Arlington’s EMS operations manager. The whole blood program was launched jointly by the Arlington Fire Department, AMR Arlington and Medical City Arlington.

Dr. Mark Yazer, a professor of pathology at the University of Pittsburgh and an expert on whole blood, said whole blood is better for patients who have suffered blood loss because it restores plasma, platelets, and red blood cells altogether.

Using saline, or crystalloid fluids, in case of blood loss is actually harmful for patients, Yazer said.

“What we now know is that saline contributes to mortality in patients in hemorrhagic shock,” Yazer said.

Saline solutions and crystalloids “have no oxygen-carrying capability, no clotting factors. They have none of the components necessary to sustain life,” Weinzapfel said.

“We anticipate seeing dramatic improvement in trauma mortality rates and dramatic improvement in trauma complication rates,” said Sharn Barbarin, CEO at Medical City Arlington.

“Before, we were limited on what we could do for a patient that had a traumatic insult like that, and really kind of our only answer was to start an IV, get what we call TxA [tranexamic acid], which helps with the kind of the blood clotting portion of it, and drive fast to get to the hospital, hoping that we get there in time,” Weinzapfel said.

Only about 300 of the nation’s 23,000 EMS agencies carry whole blood, according to whole blood expert Randall Schaefer. Dallas and Fort Worth first responders also carry whole blood. Arlington took inspiration from its neighbors as well as San Antonio’s and Frisco’s whole blood programs, Weinzapfel said. Arlington’s first responders started planning the whole blood program toward the end of 2023.

There will be three units in the EMS system carrying whole blood, Weinzapfel said, and when a call comes in that meets blood dispatch criteria (or a crew is requesting blood) the closest unit will get dispatched to the call.

Everyone in Arlington’s EMS system has been trained on how to give blood. Part of the Arlington team’s training also included being able to recognize patients with religious beliefs that prohibit receiving blood transfusions, like Jehovah’s Witnesses, said EMS lieutenant Jason Adams.

The majority — about 75% — of whole blood will go to trauma patients, with the rest going to medical patients, Weinzapfel said.

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