When a patient suffers a traumatic injury or major bleeding (hemorrhage), rapid blood transfusion can be the difference between life and death. Traditionally, these transfusions occur only after a patient reaches the hospital. Now, thanks to the American Red Cross and the generosity of local blood donors, DC Fire and EMS brings this lifesaving treatment directly to patients in the field. 

Launched in 2024, the program has been operating for more than two years. Early whole blood transfusion by EMS has been shown to more than double the chances of survival for patients with severe blood loss. In 2025, the program received the 22nd Annual Cafritz Team Innovation Award, recognizing its impact, technical excellence, and lifesaving service to the District.  

As of June 22, 2026: 

• 532 units of whole blood administered 
• 492 patients treated 
• 365 lives saved (excluding traumatic cardiac arrest) 
• 93% survival rate among treated patients (excluding traumatic cardiac arrest) 
• Whole blood can reach any part of the District in 10 minutes or less  

What types of patients may benefit from whole blood? 

Whole blood can be lifesaving for patients experiencing severe blood loss from: 

• Motor vehicle crashes and other highforce blunt trauma 
• Penetrating injuries, including gunshot wounds and stabbings 
• Crush injuries 
• Traumatic amputations 
• Severe gastrointestinal bleeding 
• Ruptured blood vessels (such as aortic rupture) 
• Lifethreatening bleeding during or after childbirth 

These patients rapidly lose red blood cells, plasma, and platelets. Whole blood replaces all of these components at once.  

Where does whole blood come from? 

Blood is donated by volunteers through the American Red Cross. Each unit is: 

• screened and tested 
• filtered to remove white blood cells 
• confirmed to have low levels of antiA and antiB antibodies (“lowtiter”) 

Blood is stored at the George Washington University Hospital Blood Bank, which prepares and distributes units to temperaturecontrolled, monitored storage devices placed in EMS supervisor units and select firehouses across the District.  

Want to see how we transport and store whole blood? 
Watch our short overview video: 
https://www.youtube.com/watch?v=6lqhtSEk1fg  

What type of blood does DC Fire and EMS transfuse? 

We transfuse lowtiter Type O whole blood (LTOWB), considered the universal emergency blood product. 

• “Lowtiter” means the blood has low levels of antibodies, reducing the risk of reactions. 
• Type O blood can be given to any patient, regardless of blood type. 
• Units may be Opositive or Onegative, depending on supply. 
• Whole blood contains red blood cells, plasma, and platelets—everything needed to replace what is lost during severe hemorrhage. 

Are whole blood transfusions safe? 

Yes. Whole blood has been safely used for more than a century and is administered in trauma centers throughout the United States. Prehospital whole blood is now used by hundreds of EMS systems, with severe reactions being extremely rare.  

DC Fire and EMS paramedics undergo extensive training in transfusion procedures, patient monitoring, equipment use, and recognition and management of any potential reactions.  

Who is eligible to receive whole blood? 

Paramedics may administer whole blood to patients who: 

• are over one year old, 
• have significant traumatic or medical bleeding, and 
• show signs of hemorrhagic shock. 

Eligibility is determined using DC Fire and EMS clinical protocols, which also guide the procedure for administering transfusions.  

Can children receive whole blood? 

Yes. Working in partnership with Children’s National Hospital, DC Fire and EMS developed pediatric transfusion guidelines that allow for transfusion in children older than one year. Paramedics consult with pediatric emergency specialists before transfusing any patient ages 1–15.   

Can a patient refuse a transfusion? 

Yes. 

• Conscious adults with decisionmaking capacity may decline transfusion. 
• Parents or guardians may consent or decline for minors when present. 
• When a patient is unconscious or critically injured and delaying care would threaten the patient’s life, paramedics act under emergency protocols to provide lifesaving treatment. 

Paramedics also check for medical alert tags, wallet cards, or advance directives prior to transfusion.  

Will every fire station and ambulance carry whole blood? 

Not at this time. Whole blood is a limited resource that requires specialized training. DC Fire and EMS deploys whole blood with trained EMS supervisors strategically located across all six battalions. Supervisor units can respond within minutes to any request. 

The deployment strategy ensures whole blood can reach any location within 10 minutes.  

Are DC hospitals transfusing whole blood? 

Yes. Whole blood is used in emergency departments and trauma centers across the District,. 

Does early whole blood transfusion make a difference? 

Yes. Research from civilian trauma centers, military medical systems, and national trauma registries shows that patients who receive whole blood sooner—especially before or shortly after reaching the hospital—have significantly higher survival rates. Studies demonstrate that early transfusion rapidly stabilizes patients in hemorrhagic shock, improves their chances of surviving the first critical hours after injury, and reduces overall mortality, with measurable survival benefits appearing within minutes of receiving blood. Delays in transfusion, even as short as 10–15 minutes, have been shown to decrease the likelihood of survival. Together, these findings make early whole blood transfusion one of the most effective interventions available for patients experiencing life-threatening bleeding. 

What if a patient develops a transfusion reaction? 

Transfusion reactions in the field are rare. Paramedics trained in whole blood administration are taught to identify and treat reactions immediately, including stopping the transfusion, administering emergency medications, and transporting the patient promptly to the hospital.