New NEMSIS Report Highlights Rapid Growth of Prehospital Blood Transfusion in EMS Systems Nationwide
SALT LAKE CITY— A newly released report from the National Emergency Medical Services Information System (NEMSIS) provides a comprehensive national snapshot of blood product administration in prehospital care, underscoring a significant shift in how EMS agencies manage hemorrhage and shock in the field.
Analyzing data from 2024–2025, the report documents more than 48,000 EMS blood transfusions nationwide, including more than 22,000 administered during ground ambulance responses. The findings reflect continued momentum in the adoption of prehospital blood programs, particularly among agencies seeking to improve outcomes for patients experiencing severe trauma or medical bleeding.
Whole Blood Leads the Way
Among the most notable trends is the predominance of whole blood, which accounted for approximately 62% of documented transfusions during ground transport and 23% of transfusions overall. This aligns with a broader shift in both civilian and military medicine toward simplified, balanced resuscitation strategies in hemorrhagic shock.
Other blood products, including packed red blood cells, plasma, and platelets, were used less frequently, while a portion of cases did not specify the product administered—highlighting ongoing opportunities to improve documentation.
Rural EMS Agencies at the Forefront
Rural EMS agencies accounted for the largest share of prehospital transfusions, representing roughly 42% of cases. Urban systems followed at 35%, with suburban and frontier areas making up smaller proportions.
This trend likely reflects the unique challenges of rural care, including longer transport times and limited access to trauma centers, where early blood administration can play a critical role in patient survival.
Beyond Trauma: Expanding Clinical Use
While trauma remains a primary driver of prehospital transfusion—particularly motor vehicle crashes and penetrating injuries—the report also highlights substantial use in non-traumatic conditions.
Among medical cases, gastrointestinal bleeding, generalized hemorrhage, and shock were the most common indications, demonstrating that EMS clinicians are increasingly leveraging blood products across a broader range of critical presentations.
Supporting the Future of EMS Care
The report emphasizes the importance of continued investment in training, protocols, and data quality to support the safe and effective expansion of prehospital blood programs. Improved documentation and standardization will be essential to fully understand outcomes and guide future best practices.
As EMS systems nationwide continue to evolve, the integration of blood products into prehospital care represents a critical advancement in the ability to treat life-threatening hemorrhage earlier—when minutes matter most.
Download the report and visit NEMSIS.org for more information.
About NEMSIS
The National Emergency Medical Services Information System (NEMSIS) is the national system used to collect, store and share EMS data from the U.S. States and Territories. NEMSIS develops and maintains a national standard for how patient care information resulting from prehospital EMS activations is documented. This information is voluntarily submitted to the National EMS Data Repository at NEMSIS by State and Territory EMS Officials.
NEMSIS is a collaborative system to improve prehospital patient care through the standardization, aggregation, and utilization of point of care EMS data at a local, state, and national level. NEMSIS is a program of NHTSA’s Office of EMS and hosted by the University of Utah.
