Northfield, Ill. (November 18, 2025) — The College of American Pathologists (CAP) recommends expanding the ability of emergency personnel to provide prehospital blood transfusions to improve survival rates after traumatic injury.
“Allowing ground and air ambulances to start blood transfusions when needed will save lives,” said CAP President Qihui “Jim” Zhai, MD, FCAP. “We’ve found only a small number of emergency transport programs carry blood products even though state laws grant them the authority to do so. We hope to raise more awareness of the benefits and lifesaving potential of prehospital transfusions.”
Hemorrhage is the leading cause of potentially preventable death after traumatic injury, with up to 55% of these deaths occurring before patients reach the hospital. Prehospital blood transfusion programs could save as many as 10,000 lives each year, yet only about 2% of ground EMS programs currently carry blood products.
In a new position statement, the CAP urges states with limited guidance to update EMS scope-of-practice laws to allow paramedics and other trained personnel to initiate blood transfusions in the field. While most states allow EMS personnel to start transfusions under physician oversight, the CAP urges the remaining states with restrictions to update their regulations so that patients nationwide have equal access to this lifesaving care.
The CAP also supports expanding access to blood products for both ground and air ambulances, along with continued research to strengthen prehospital transfusion programs and maintain a stable national blood supply. The CAP emphasizes the importance of donor recruitment, supply chain resilience, and reducing blood wastage to ensure hospitals and EMS agencies alike have the resources they need.
The full position statement, “Support of Prehospital Blood Transfusion,” is available on the CAP Newsroom.
Talk to an expert: Matthew S. Karafin, MD, FCAP, chair of the Transfusion, Apheresis, and Cellular Therapy Committee, is available for interviews. Contact media@cap.org for more information.
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About the College of American Pathologists
As the world’s largest organization of board-certified pathologists and leading provider of laboratory accreditation and proficiency testing programs, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. For more information, visit the CAP Newsroom, CAP.org and yourpathologist.org to watch pathologists at work and see the stories of the patients who trust them with their care.