In an effort to improve outcomes for patients with hemorrhagic shock, over 400 civilian emergency medical services (EMS) systems have established prehospital whole blood transfusion programs.1 Trauma patients in hemorrhagic shock face a sharply increased risk of bleeding-related death within the first 24 hours. Hemorrhage remains the leading cause of preventable death after injury in the USA.2 Furthermore, recent data have shown a 2% increase in the odds of 24-hour and 30-day mortality for every 1-minute delay in prehospital resuscitation for blunt and penetrating trauma patients.3 There is also recent evidence that earlier transfusion of whole blood is associated with improved odds of survival at 24 hours and 30 days.4 5
EMS blood program coordinators play essential roles in every aspect of prehospital blood transfusion programs. Quite simply, the lifesaving potential of prehospital blood programs depends on their ability to manage numerous responsibilities. O’Byrne et al have proposed a framework to describe the knowledge, skills, and abilities for this essential role.6 One of the challenges faced by new and existing blood programs lies in harnessing a complex body of knowledge in a variety of different domains. Many new coordinators currently “learn as they go” from mentors in other locales.
Coordinators must have clinical and logistical aptitude, as well as the ability to develop and maintain effective partnerships with blood banks and hospital partners. As blood is a precious resource, this collaborative effort ensures proper cold chain storage and minimizes waste. They must also have the ability to synthesize data to inform the blood deployment model, evaluate patient outcomes, and analyze the appropriateness of blood transfusion. Finally, coordinators must implement quality improvement initiatives, organize training, and ensure the program meets all regulatory requirements.
I applaud the authors for highlighting the central roles of EMS blood coordinators. This framework provides for standards associated with this core position. As standards are incorporated into initial and continuing education for coordinators, they will augment the reliability and sustainability of EMS blood programs. With the rapid expansion of prehospital blood programs nationwide, a consistent framework for EMS blood coordinators’ responsibilities is timely.
Footnotes
Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Patient consent for publication: Not applicable.
Ethics approval: Not applicable.
Provenance and peer review: Commissioned; internally peer reviewed.
References
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