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DENTON — Caroline County’s Department of Emergency Services is preparing to launch a “whole blood” transfusion program. In a presentation to the County Commissioners on December 16, Dr. Kyle Fratta, Medical Director for Caroline County Department of Emergency Services, Mark Sheridan, Director of the Department, and KJ Marvel, Division Chief for Emergency Medical Services, said the program could significantly improve survival rates for patients experiencing catastrophic bleeding. Once implemented, Caroline County will be the first county on Maryland’s Eastern Shore to offer pre-hospital blood transfusions.
The initiative will allow emergency medical crews to administer “low-titer O+ whole blood” to patients at the scene of an emergency or while en route to the hospital. Whole blood contains red blood cells, plasma, and platelets. Dr. Fratta said it’s essentially the same blood that runs through the human body, just filtered and screened for safety. Unlike some transfusions that administer individual components of blood, whole blood allows patients to receive whatever they need most, whether that is red blood cells to carry oxygen to organs such as the brain, or platelets and plasma to speed up clotting and stop bleeding.
“This is a very low-risk intervention,” Dr. Fratta said, “It is filtered whole blood, so there’s very little antibodies in it, very few people have reactions to this.” Dr. Fratta emphasized that the blood is fully tested, tightly temperature-controlled, and tracked from donor to patient. It is already used daily by the U.S. military, other EMS departments, and the Maryland State Police Aviation Unit.
Dr. Fratta told Commissioners that hemorrhage is the number one cause of preventable death in the United States, and studies show a 10 to 20 percent improvement in survival for patients in hemorrhagic shock when whole blood is administered early. “We’re talking about one in 10 to one in five [patients] will survive because of blood,” Fratta said, “It buys people time, time that we really don’t have, especially in a county without a trauma center.”
Early administration of whole blood can also reduce the need for massive transfusions later, mitigate injuries before they worsen, and lessen the impact of oxygen deprivation to the brain, meaning fewer patients may experience long-term brain damage. Currently, Caroline County patients needing emergency blood transfusions must wait until they arrive at a hospital or rely on Maryland State Police helicopters, which carry whole blood but are not always available and can still take significant time to reach a scene.
To describe just how life-altering this program promises to be, Sheridan said, “I’ve been in EMS for almost forty years, and I compare this to when CPAP came out, which is where you basically put a mask on someone that’s having trouble breathing.” He explained that while other measures taken by EMS during a medical emergency can sometimes exacerbate the problem, whole blood transfusions pose “very little risk.”
Funding for the program has come largely through grants. The Caroline Foundation awarded a $20,000 grant to support the effort. Sheridan noted that while the original budget was estimated at about $32,000, the department has not yet needed that full amount, having spent roughly $5,000 in addition to the Caroline Foundation’s contribution. They are currently applying for additional grants.
Commissioner Larry Porter acknowledged the role of the Caroline Foundation and its leader, Terry Mead, who attended the meeting. Also recognized for their contributions to the program were the Caroline County Health Department, for providing freezers to store blood at the proper temperature, and the Blood Bank of Delmarva, who will supply the blood at no cost to the county.
Officials hope to begin implementing the program by February 2026. While every ambulance will be equipped with the necessary supplies to administer blood, the blood itself will remain under the oversight of a supervisor. When needed, an ambulance crew can prepare and be ready for transfusion as the blood is delivered. “This is the most cost-effective route,” Sheridan said, adding that this model is used by most counties with similar programs.
According to projections, the program is expected to save the lives of one to two people per year in Caroline County who would otherwise be lost en route to a trauma center. Emergency Services anticipates administering between 12 and 25 pre-hospital whole blood transfusions annually, which will not only save lives, but improve outcomes and recovery times for many patients.
Commission President Travis Breeding said, “I think it’s a necessary step. If we can save a life or two a year… that’s a major accomplishment.”
