Prehospital Trauma Compendium: Transfusion of Blood Products in Trauma – A Position Statement and Resource Document of NAEMSP

The National Association of Emergency Medical Services Physicians (NAEMSP) recommends, in EMS agencies/systems that can support a high-quality prehospital blood transfusion program:Use of blood components over crystalloids for the first-line treatment of patients with traumatic life-threatening bleeding in the prehospital phase of resuscitationUse of low titer group O whole blood (LTOWB) as the first-choice blood product for treatment of patients with traumatic life-threatening bleeding in the prehospital phase of resuscitationUse of a combination or composite of prehospital transfusion indications, focused on physiologic abnormalities and/or injury patterns with obvious significant blood loss.Use of active monitoring for transfusion-related adverse events.Developing a mechanism to recycle unused blood product units nearing their expiration date to a high-use hospital facility to minimize wastage.Engaging in a comprehensive longitudinal active collaboration between EMS agencies, trauma centers, and blood suppliers to ensure the success of a prehospital transfusion program.