Operationalizing the Deployment of Low-Titer O-Positive Whole Blood Within a Regional Trauma System

ABSTRACT Introduction The implementation of a low-titer O+ whole blood (LTOWB) resuscitation algorithm, particularly in the prehospital environment, has several inherent challenges, including cost, limited and inconsistent supply, logistics cold-chain management. Southwest Texas Regional Advisory Council implemented nation’s first multidisciplinary, multi-institutional regional LTOWB program. This research effort was to illustrate successful deployment within trauma system. Materials Methods A deliberate systems approach used. Tenets this program included active management donor sources supply levels minimize wastage as result expiration, maximize product utilization, use transfusion triggers, efforts decrease costs agencies. novel rotation system established using concept “rotation site” center.” Standardized criteria, approved equipment list, Prehospital Blood Product Transfusion Record, robust multilevel communication plan serves framework for San Antonio Whole Consortium developed create consensus driven forum manage guide Results From January 2018 October 2019, been placed at 18 helicopter emergency medical services (HEMS) bases, 12 ground service (EMS) agencies, 1 level I center, IV center. total 450 patients have received transfusion. Program wide, rate due expiration is between 1% 2%. No complications related administration identified. Discussion work demonstrates model development program’s augments remote damage control strategies requires integration collaboration multidisciplinary stakeholder team optimize efficiency, performance, safety