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The program that enables emergency responders in San Antonio to give prehospital hemorrhagic shock patients whole blood is marking its fourth anniversary with more than 1,000 patients transfused.

Launched in October 2018, the program transfused its 1,000th patient in mid-September, said C.J. Winckler, MD, LP, associate professor/clinical in the Department of Emergency Health Sciences and an associate professor in the Department of Emergency Medicine.

That 1,000th patient was hypotensive and in hemorrhagic shock when transfused with whole blood, “a treatment we did not have before Oct. 1, 2018,” said Winckler, who also serves as deputy medical director of EMS for the San Antonio Fire Department (SAFD) and is a leader and researcher in the use of whole blood transfusion by emergency responders. He is also an author on a .

“The program is strong and resilient and supported the other blood service lines during the pandemic,” Winckler said. “Platelets ran out for surgeries — not just in San Antonio but in the state and south Texas — and we had to use the whole blood to support some of the other blood service lines during the pandemic.”

In addition to transfusing whole blood to individual patients as part of the region’s emergency response system, the program also makes whole blood available to mass casualty events, including the elementary school shooting in Uvalde in May.

“We had 20 units of blood at the scene and flew 20 to 30 units there from the blood and tissue center,” Winckler said. “We transfused at the hospital. The (whole blood) units are on ambulances and helicopters ready to respond.”

The program’s low-titer, O-positive blood is donated through the Brothers in Arms project administered by the South Texas Blood and Tissue Center. Blood that isn’t used within 14 days is given back to the South Texas Blood and Tissue Center to be tested and used for hospital transfusions.

“None of the blood gets wasted,” Winckler said.

Along with the Southwest Texas Regional Advisory Council (STRAC), the program also hosts a whole blood academy to teach other EMS agencies and fire departments about best practices for organizing a whole blood program. For more information, email Winckler.