Henrico County paramedics can now give trauma patients a transfusion before they reach a hospital. The county's Division of Fire has expanded its pre-hospital whole blood program countywide, meaning every trained paramedic in Henrico can administer Low-Titer O Positive Whole Blood to qualifying patients in the field, before they ever reach a hospital.
The rollout follows an initial pilot in the western portion of the county in October, according to Henrico Citizen. Whole blood contains red cells, plasma and platelets together, which the department says makes it useful in severe bleeding emergencies when every minute counts. To get here, all Henrico paramedics completed weeks of specialized training for the expanded service.
Henrico Fire's operational medical director, Jeffrey Ferguson, said the addition gives crews a critical tool in the minutes after a traumatic injury. Equipping paramedics with whole blood, he said, is about “helping patients buy more time until they get to the hospital.” Ferguson also said whole blood is the best alternative available for resuscitating a patient who is in shock from blood loss, according to the same report.
How Henrico Keeps Blood Flowing to Crews
Supplying enough blood to stock ambulances across an entire county is its own logistical challenge, and Henrico is handling it through a partnership with Inova Blood Donor Services. The county is also taking part in a zero-waste arrangement designed so that units approaching the end of their field-use period don't simply get discarded — instead, they can still be used appropriately elsewhere within the health system, per the department's account.
Henrico's approach echoes similar efforts cropping up across Virginia. A Chesterfield County program launched in June 2023 in partnership with Virginia State Police's Med-Flight initiative and Chesterfield Fire & EMS has since expanded to Hanover, Dinwiddie, Buckingham and Goochland counties, with the service administered 85 times since launch, according to WTVR. Goochland Fire & Rescue Deputy Chief Mike Watkins said that county's crews had deployed the program nine times since joining in September. That regional network returns unused blood to a hospital if it hasn't been used within two weeks, the station reported.
What the Research Says About Field Transfusions
The push toward earlier blood administration in the field isn't unique to Virginia. A report on a trauma study found lower in-hospital mortality among patients who received prehospital whole blood compared with those who got crystalloid fluids alone, according to the American College of Surgeons. The same report described an 11.2 percent absolute risk reduction in mortality for whole blood versus crystalloid, with an estimated number needed to treat of about nine to prevent one additional death.
Not every study paints as dramatic a picture. A systematic review snippet cited by ScienceDirect reported no demonstrable survival difference between prehospital whole blood and component therapy, though it noted that safety outcomes in that analysis were estimated with limited evidence. Elsewhere, a regional report from the Southern Maryland Chronicle noted that trauma programs nationally have increasingly moved toward giving whole blood as early as possible to patients with severe hemorrhage.
The urgency behind these programs is also tied to blood supply pressures. A report on the Chesterfield-area expansion noted that the American Red Cross had declared an emergency blood shortage, underscoring why programs like Henrico's rely on structured partnerships with suppliers such as Inova rather than ad hoc sourcing.
Lessons From Other Counties' Programs
In Calvert County, Maryland, career EMS supervisors have carried low-titer Type O positive whole blood since November 15, 2025, with each supervisor carrying two units along with the equipment needed to store and administer them, the Southern Maryland Chronicle reported. That program rotates blood every 14 days, with unused units returned to Inova Health System's blood donor services for hospital use — a cycle similar in spirit to the zero-waste arrangement Henrico has described for its own supply.
Calvert County Commissioner Catherine Grasso said at an Oct. 20 meeting that four residents would have died without the county's whole blood program. The outlet also noted that Calvert has not publicly reported what its program costs or how many patients have received blood since the program began, and a separate account described Calvert's effort as Maryland's fifth prehospital EMS agency authorized to give whole blood and the first in Southern Maryland.
Henrico has not released figures on how many units it has used, how many vehicles or stations are equipped, or how many patients have received transfusions since the countywide expansion began. For now, the county's message centers on preparedness: a trained paramedic workforce, a steady supply line through Inova, and a system meant to waste as little blood as possible while giving critically injured residents a better shot at survival before they ever reach an emergency room.
