{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:45:55Z","timestamp":1790455555035,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Whole blood (WB) is an attractive product for prehospital treatment of hemorrhagic shock and for initial in\u2010hospital resuscitation of patients likely to require massive transfusion. Neither our regional blood provider nor our hospital blood bank had recent experience collecting or using WB, so we developed a stepwise process to gather experience with WB in clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>When our Transfusion Committee suggested a WB program, we worked with our regional blood provider to collect cold\u2010stored, leukoreduced, low\u2010titer anti\u2010A, and anti\u2010B group O RhD positive WB (low\u2010titer group O WB [LTOWB]) and worked with our city Fire Department to integrate it into prehospital care. This work required planning, development of protocols, writing software for blood bank and electronic medical records, changes in paramedic scope of practice, public information, training of clinicians, and close clinical follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between June 2019 and December 2021, we received 2269\u2009units of LTOWB and transfused 2220\u00a0units; 24 (1%) were wasted, two were withdrawn, and 23 were in stock at the end of that time. Most (89%) were transfused to trauma patients. Usage has grown from 48 to 120\u2009units\/month, covers all 5 Fire Districts in the county, and represents about \u00bc of all hospital trauma blood product use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Developing a WB program is complex but can be started slowly, including both pre\u2010hospital and hospital elements, and expanded as resources and training progress. The investments of time, effort, and funding involved can potentially improve care, save blood bank and nursing effort, and reduce patient charges.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17018","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T09:14:50Z","timestamp":1657530890000},"page":"1699-1705","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["How we built a hospital\u2010based community whole blood program"],"prefix":"10.1111","volume":"62","author":[{"given":"Joel","family":"Addams","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saman","family":"Arbabi","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Washington School of Medicine  Seattle Washington 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Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8596-4420","authenticated-orcid":false,"given":"John R.","family":"Hess","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Washington School of Medicine  Seattle Washington USA"},{"name":"Harborview Injury Prevention Research Center Harborview Medical Center  Seattle Washington 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