America’s Blood Centers (ABC) has responded to the Agency for Healthcare Research and Quality’s (AHRQ) November 26th request for “Supplemental Evidence and Data Submission on Prehospital EMS Blood Transfusion and Fluid Interventions for Hemorrhagic Shock.” In the comments to AHRQ, ABC highlighted the important role that its member blood centers play in prehospital blood transfusion programs nationwide and described impediments to implementing and maintaining such programs.
Specifically, the ABC AHRQ prehospital blood comments included aggregate survey data from ABC members regarding prehospital blood transfusion programs from 2022 to 2024 that demonstrated the impact of community blood centers to prehospital blood transfusion programs. Of note, ABC member blood centers have increased their participation in prehospital blood transfusion programs from 18 in 2022 to 34 member blood centers in 2024. The total number of reported blood products distributed via these programs also increased from 14,882 units in 2023 to 32,202 units in 2024 with low titer group O whole blood (LTOWB) making up 13,452 units in 2024 versus 5,015 in 2023.
ABC explained in the comments that, [t]he most consistent barrier for ABC member blood centers regarding prehospital blood transfusion programs, “is [a] lack of funding [with] operational costs at blood centers already [being] strained. [While additional barriers] that contribute to the reluctance by blood centers to implement a prehospital blood program are the risk of product wastage and the logistical burdens of rotating product between locations to prevent wastage.”
The ABC AHRQ prehospital blood comments noted more, “clarification is needed on the definition of group O whole blood” including:
- leukoreduced vs. non-leukoreduced;
- cutoff values for low titer;
- age of units; [and]
- Rh (D) positive vs. Rh (D) negative.
ABC also recommended in the comments that, “a revision of the bag system to use an anticoagulant that would allow storage longer than 21 days that would preserve function of both red blood cells and platelets is worth further study, especially as new di(2-ethylhexyl) phthalate (DEHP) free bag systems are developed.”
The full ABC AHRQ prehospital blood comments are available. Ensuring blood transfusions are available to all patients when and where they need blood is a top priority in ABC’s Advocacy Agenda. ABC will continue to provide updates on its advocacy efforts as they become available.