Caroline County to carry prehospital whole blood on EMS supervisor units

Mark Sheridan, director of Caroline County Emergency Services, and Dr. Bridal, the department’s medical director, presented a plan Dec. 16 to carry and administer prehospital whole blood on supervisor EMS units to improve survival in severe hemorrhage and trauma cases.

Sheridan said the program is aimed at a county that lacks a hospital and long transport times to trauma centers. "We are initiating a whole blood program," he said, calling it "an important initiative in a county with no hospital." Dr. Bridal described whole blood’s clinical benefits, saying that in trauma settings "we're talking about 1 in 10 to 1 in 5 will survive because of blood," and that whole blood can buy time when helicopters or trauma-center transport are delayed.

Presenters described a partnership with Delmarva Blood Bank and funding principally provided by the Caroline Foundation. The program’s initial equipment budget was estimated at roughly $32,000; speakers said the Caroline Foundation awarded a $20,000 grant and county equipment outlay is about $5,000. The county also acquired a freezer from the Maryland Department of Health stockpile at no cost, which staff said avoided roughly a $10,000 purchase.

Operational details provided to commissioners included that supervisor trucks will carry one 250–500 ml unit, equipment will include a LifeFlow/QuinFlow rapid-administration pump and a blood warmer, and an administration typically takes about five minutes. Staff said coolers will be alarmed and linked to phone notifications if a temperature excursion is predicted; whole blood must be kept between 2°C and 6°C and will be rotated with the blood bank on a 14-day schedule to avoid waste.

Sheridan and Dr. Bridal projected 12–25 transfusions per year countywide and estimated the program could save "likely 1 or 2 people per year" who otherwise might have died en route. Training has begun department-wide; additional hands-on training with Howard County and Delmarva is planned in January, with an operational target of February dependent on final protocols and staffing.

County staff said QA oversight will be provided by the department’s QA/QI team and blood-bank partners, and that the program will operate under protocols reviewed and signed by the county medical director and the blood bank. The board did not take formal action on the presentation; next steps include completion of training, final sign-offs of written protocols by the medical director and blood-bank partners, and a staff report on operational readiness ahead of the planned launch.

The program partners and funding sources named by presenters were Delmarva Blood Bank and the Caroline Foundation; staff also said they expect to seek additional grant support for product costs if they qualify for hospital grant programs. The county will return to the commission with implementation updates.