CHARLESTON, W.Va. — West Virginia’s Department of Health says the state’s initial implementation for the administration of whole blood on ambulances has so far been successful for two counties who have been utilizing the service after West Virginia became the first to roll out statewide protocols for it.

The Department of Health’s Director of the Office of Emergency Medical Services, Jody Ratliff told 580 WCHS that Cabell County EMS began offering the service in November 2023 and Harrison County followed suit just last month.

“Everything has been going really good, I know that Cabell County EMS has administered whole blood on I believe two occasions, I’m not sure if Harrison County has had to administer it yet, but so far we’ve got a list of equipment that was approved by the state on what they have to carry, and that’s been going very smoothly,” said Ratliff.

Jody Ratliff

He said while EMS agencies across the nation develop their own protocols for how they distribute whole blood, West Virginia makes the first state to develop a statewide protocol, so Ratliff said that any ambulance service who chooses to distribute whole blood on their vehicles, they will have but one protocol they will work under.

Ratliff said the history of trauma and deaths related to trauma has shown just how great of a need it is for whole blood to be administered by EMS directly on the scene of an accident.

He said in trauma education, there is a lethal triad which EMS personnel follows that consists of what happens before a trauma death is about to occur, and that includes hypothermia, acidosis, which is a build up of acid in the bloodstream, and coagulopathy, or the impairment of the blood’s ability to coagulate or form clots.

Ratliff said historically, there are three main types of blood products that have always come in separate packages– a packet of red blood cells, frozen plasma or never frozen plasma, and platelets.

He said whenever EMS has given whole blood as opposed to those products separately, it has shown to improve a patient’s survival rate by 60% over a 30-day period. Within a 24-hour period of receiving whole blood, Ratliff said the need for all three blood products was reduced by 7%.

Ratliff said it was time for EMS agencies on the ground to start offering whole blood, as its impact was something which air medical personnel had already recognized and started implementing.

“The need for it in trauma, especially rural areas, was a need that our helicopter services in the state recognized years ago and started carrying packed red blood cells and what’s called never frozen plasma, and now they have started to move towards whole blood,” he said.

Ratliff said while originally the options were to either distribute whole blood to patients being airlifted, or as soon as they arrive at a local hospital, placing the blood directly on the ambulance will help expedite the process of saving lives.

“If I’m in Lincoln County and I’m heading towards Huntington, Cabell County EMS can treat that patient and administer blood while en route to the trauma center,” he said.

However, Ratliff said keeping whole blood on ambulances is not only a good move from the patients’ standpoint, but he said it will help EMS providers and trauma centers operations go more efficiently, as well.

“They definitely know the benefits of receiving that whole blood as soon as you can transfuse in a trauma-setting, so it should and it will improve survival rates in West Virginia,” said Ratliff.

Ratliff said there are now about four other EMS agencies in the state who are in the works of implementing the whole blood distribution on ambulances, as well.