Whole Blood in Trauma: A Review for Emergency Clinicians

Wells Weymouth, Brit Long, Alex Koyfman, Christopher Winckler

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Background: Blood products are a cornerstone of trauma resuscitation. From the historically distant battlefields of World War II through present-day conflict around the globe, whole blood (WB) has been a potent tool in the treatment of massive hemorrhagic shock. Component therapy with a targeted ratio of packed red blood cells, platelets, and plasma has previously been utilized. Objectives: This narrative review describes modern-day WB transfusion, its benefits, potential drawbacks, and implementation. Discussion: The current form of stored low-titer O WB seems to be the safest and most effective solution. There are many advantages to WB, including the maintenance of coagulation factors, the lack of subsequent thrombocytopenia, and the reduction of infused anticoagulant. Several studies suggest its utility in trauma. Most of the disadvantages of WB stem from a lack of prospective data on the topic, which are likely forthcoming. Logistical issues likely present the greatest barrier to this therapy, but an advanced prehospital protocol developed in San Antonio, Texas, has successfully overcome several of these challenges. Conclusions: Although stored WB holds promise, it is not without its distinct challenges, including logistical issues, which this article addresses. There are programs underway currently that demonstrate its feasibility in metropolitan areas. As demonstrated in military settings, WB is likely the ideal resuscitation fluid for civilian trauma in the prehospital and emergency department settings.

Original languageEnglish (US)
Pages (from-to)491-498
Number of pages8
JournalJournal of Emergency Medicine
Issue number5
StatePublished - May 2019


  • blood products
  • protocol
  • transfusion
  • whole blood

ASJC Scopus subject areas

  • Emergency Medicine


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