In a windfall for small and rural emergency medical services especially, the Texas Legislature allocated $10 million in the state’s 2026-2027 budget to a pilot program to support administering whole blood in the field to patients with extreme blood loss due to trauma, maternal hemorrhage, or other significant medical conditions.
“This $10 million allocation is a godsend to us,” Alan Tyroch, MD, said. The El Paso trauma surgeon and consultant to the Texas Medical Association’s Committee on Emergency Services and Trauma chairs the Governor’s EMS and Trauma Advisory Council (GETAC).
Dr. Tyroch emphasizes whole blood’s primacy across a swath of medical circumstances and complications that might present to EMS personnel.
“It’s a better fluid,” he said. “It’s not just for the trauma patient. The obstetrical patient that’s bleeding, the gastrointestinal bleeder, like cirrhotics. I give it to my general surgery patients that are having a major operation that need help. So, it’s not just for the trauma population.”
GETAC’s Whole Blood Task Force aligned with TMA, the Texas EMS Alliance, and other stakeholders to campaign for a $4 million state budget rider to facilitate prehospital whole blood, which can be prohibitively costly, especially for rural, volunteer agencies that might transport patients over great distances from small hospitals to Level I trauma centers.
“That’s where it’s needed, as a patient’s being picked up and transferred to the tertiary trauma centers,” Dr. Tyroch said. “One of the problems that people are facing across the country is that an ambulance can’t bill for blood, so they’re going to be eating a cost.”
The American College of Surgeons estimates that prehospital whole blood has the potential to save thousands of lives nationally per year, but only about 1% of EMS units in the country, including air medical units and ambulances, carry blood currently. Crystalloid fluid solutions that don’t carry oxygen have been used in lieu of whole blood by paramedics and in trauma centers, in tandem with blood components, but aren’t as effective.
The legislature’s appropriation for the pilot in Senate Bill 1, the General Appropriations Act looks to change that in Texas.
The Southwest Texas Regional Advisory Council, one of 22 councils in the state that provide trauma system oversight, has led the way in expanding both awareness and the provision of prehospital whole blood through its cooperative regional whole blood program and national Whole Blood Academy, an annual event in San Antonio that promotes collaboration and system building among paramedics, training officers, blood banks, and trauma surgeons.
Attending the Whole Blood Academy as part of the Border Regional Advisory Council spurred Dr. Tyroch to assemble a GETAC task force to push for prehospital whole blood across the state.
“We [didn’t] want to ask for too much. … So we asked for $4 million over two years and, to our surprise, it came out as $10 million. That’s to fund EMS, to give the blood, to store the blood, [and for] the administrative component.”
The Texas Department of State Health Services (DSHS) will define the structure, process, and funding distribution for the statewide program. In consultation with regional advisory councils, DSHS will determine the most cost-effective method for securing the required resources for EMS agencies to operate whole blood programs.
“It took a lot of people – not just physicians, but various people working together as stakeholders on behalf of the citizens of Texas to make this happen. It took a team,” Dr. Tyroch said.
Jessica Ridge
Reporter, Division of Communications and Marketing
(512) 370-1395