Blood on the Ground: Whole Blood, Components, and the Battle for Better Prehospital Care

In this episode of Tac Medic Whiskey, Dr. Stephen P. Wood dives deep into one of the most urgent—and controversial—topics in trauma care: the use of prehospital whole blood. Drawing on military data, civilian trials, and boots-on-the-ground experience, this episode explores why whole blood saves lives, why component therapy may fall short in the field, and what’s holding back broader implementation.

Dr. Wood tackles everything from hemorrhagic shock and logistics of field transfusion to walking blood banks, cold-stored platelets, and freeze-dried plasma, all while challenging the institutional inertia that puts patients at risk. He also shines a light on the equity gap—why elite teams get whole blood while underserved urban communities often go without.

 

• Eastridge BJ, et al. Death on the battlefield (2001–2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012.

• Sperry JL, et al. Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock. N Engl J Med. 2018.

• Yazer MH, et al. Safety of low‐titer group O whole blood in trauma patients: a retrospective cohort study. Transfusion. 2018.

• Seheult JN, et al. Platelet storage conditions and transfusion outcomes: cold vs. room temperature. Shock. 2020.

• Strandenes G, et al. Cold-stored platelets: physiology and emerging data. Transfusion. 2021.