With the rise in traumatic injuries that comes with the spring, learn how EMS agencies access whole blood to help trauma patients.
FieldBrief Issue 1
Published March 24, 2026
Rapid Hemorrhage Control During Spring Trauma Season
The process for bleeding control has changed dramatically in the last year because of scope of practice changes at the state level which allowed for Cleveland EMS’s whole blood program. For first responders, that means incorporating whole blood transfusion into field protocols for patients with hemorrhagic shock.
What to Expect with Spring Trauma
With warmer weather comes a predictable shift from winter-related injuries to gunshot wounds, motor vehicle crashes and other injuries that lead to hemorrhage and other high-acuity trauma.
With the rise in traumatic injuries that comes with the spring, new tools are helping advance teams past the point of teaching the public to Stop the Bleed—expanding EMS capabilities by giving first responders access to whole blood to help trauma patients.
Bringing Whole Blood Transfusion to the Field
The State Board of Emergency, Medical, Fire, and Transportation added blood transfusion into the paramedic scope of practice in June of 2024, allowing whole blood administration in prehospital settings.
While it is not currently the standard of care, paramedics at the state level have been approved to give whole blood products in the field.
Cleveland EMS is the first and only 911 agency in Ohio to give whole blood, stocked by the MetroHealth Blood Bank. Since June, field units have been equipped to initiate transfusion prior to hospital arrival.
What This Means for EMS
- Earlier replacement of lost blood in severe hemorrhage
- Improved patient stabilization prior to hospital arrival
- Closer coordination with trauma teams upon arrival
Bystander Stop the Bleed training, provided at MetroHealth, is the first step in the chain of survival, which can be followed by other EMS interventions such as whole blood transfusion, adding another tool in the prehospital hemorrhage control toolkit.
Keep in mind:
- Massive bleeding control is step one.
- Vital sign abnormalities with a low blood pressure and high heart rate, or high shock index, will suggest hemorrhagic shock in trauma patients without obvious signs of bleeding (e.g., internal).
- Whole blood is only one piece to the complex care required to adequately and expeditiously treat severely injured trauma patients outside of a hospital.
“We are thrilled that first responders have this additional tool available in the field to stabilize hemorrhage patients before they arrive in the hospital, which gives a chance for better outcomes,” says Jeremiah Escajeda, MD, medical director, Cleveland Department of Public Safety, and a MetroHealth emergency medicine physician. “This partnership means we can continue to work together as protocols evolve to better serve our community.”
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MetroHealth Medical Center is a State of Ohio Approved Continuing Education Site #1202
Key Takeaways
- Spring trauma season often brings more gunshot wounds, crashes and other high-acuity hemorrhage cases.
- Ohio paramedics can now administer whole blood in the field to help stabilize patients with hemorrhagic shock.
- Rapid bleeding control and early resuscitation improve survival before hospital arrival.
