NEMSIS
2024–2025 Blood Transfusion Report
All EMS Blood Transfusions: 48,048 Activations (Jan. 2024 – Dec. 2025)
The first two pages of this report represent the broader EMS ecosystem, capturing a complete landscape of all EMS blood transfusions, with 20,782 occurring in 2024 and 27,266 in 2025. This overview reflects all service types and transport modes, including emergency responses, interfacility transfers, ground transport, and air medical services.
This 24-month trend highlights a significant and steady increase in blood administration across the entire EMS ecosystem.
Beginning at 1,138 activations in January 2024, utilization steadily climbed, eventually peaking at 2,576 activations in July 2025.
During this time period, the majority of blood transfusion activations occurred during air transport (53%; n=25,437), and 47% (n=22,599) occurred during ground transport, including critical care equipped units. Most of these activations occurred during interfacility transfers (51.3%; n=24,636), with emergency responses accounting for 46.5% (n=22,354).
Service Requested and Mode of Transport
The type of service initially requested and the method used to transport the patient to definitive care.
Type of Service Requested:
- Emergency Response
- Interfacility Transfer
- Other
Blood Product Administration Type
Total count of blood transfusions by blood product infused:
| Blood Product | Count | Percent |
|---|---|---|
| Whole Blood | 11,117 | 23% |
| Packed RBC | 9,036 | 18% |
| Plasma | 1,678 | 3% |
| Cryoprecipitate | 602 | 1% |
| Platelets | 424 | 1% |
| Unspecified Blood Product | 26,546 | 54% |
Total: 49,403
More than one type of blood product may be documented per activation. “Unspecified Blood Product” is used only when a blood product is administered but no specific product is documented.
What counts as an “EMS Activation”?
An EMS activation is an occurrence which initiates an EMS response with the potential of patient contact. This is also referred to as an EMS “call” or “run”.
An activation can include:
- 911 calls,
- critical care transports,
- interfacility transports,
- standby events,
- scheduled medical transports.
The data are reflected as the number of activations instead of the number of patients because there can be more than one activation per patient per call.
Patient Race
The patient’s race/ethnicity recorded by the EMS clinician. More than one race/ethnicity may be documented.
| Race | Count | Percent |
|---|---|---|
| White | 27,277 | 56.8% |
| Black or African American | 6,659 | 13.9% |
| Hispanic or Latino | 4,757 | 9.9% |
| American Indian or Alaska Native | 974 | 2% |
| Asian | 503 | 1% |
| Multiple Races | 477 | 1% |
| Native Hawaiian or Other Pacific Islander | 95 | 0.2% |
| Unknown | 7,306 | 15.2% |
Total: 48,048
Patient Age
| Age Group | Count | Percent |
|---|---|---|
| Child (0–14) | 1,891 | 4% |
| Teenager (15–19) | 2,013 | 4% |
| Young Adult (20–39) | 10,660 | 22% |
| Middle-aged Adult (40–64) | 15,311 | 32% |
| Older Adult (65+) | 17,717 | 37% |
| Unknown | 456 | 1% |
Total: 48,048
Urbanicity of Incident County
An urbanicity classification of incident county based on 2023 USDA Urban Influence Codes.
| Urbanicity | Count | Percent |
|---|---|---|
| Rural | 19,949 | 42% |
| Urban | 17,026 | 35% |
| Suburban | 6,073 | 13% |
| Frontier | 3,926 | 8% |
| Unknown | 1,074 | 2% |
Total: 48,048
Emergency Ground Ambulance Transfusions
9,876 Activations (Jan. 2024 – Dec. 2025)
The next two pages of this report represent the growing adoption of blood transfusions by ground EMS services, capturing a specific subset of 9,876 emergency ground responses, with 3,758 occurring in 2024 and 6,118 in 2025. This focused view reflects EMS blood utilization excluding the air medical and interfacility transfers seen in the broader ecosystem.
Possible Injury Among Ground Responses
EMS clinician indication of whether the patient suffered an injury.
| Possible Injury | Count | Percent |
|---|---|---|
| Yes | 6,197 | 63% |
| No | 3,026 | 31% |
| Unknown | 653 | 7% |
Total: 9,876
Blood Product Administration Type
| Blood Product | Count | Percent |
|---|---|---|
| Whole Blood | 6,310 | 62% |
| Packed RBC | 843 | 8% |
| Plasma | 288 | 3% |
| Cryoprecipitate | 528 | 5% |
| Platelets | 17 | 0.2% |
| Unspecified Blood Product | 2,124 | 21% |
Total: 10,110
Blood product types are counted separately; totals may exceed 100%. “Unspecified Blood Product” is used only when a blood product is administered but no specific product is documented.
Patient’s Primary Symptom (Medical)
The primary patient symptom resulting from an illness observed by EMS personnel.
| Primary Symptom | Count | Percent |
|---|---|---|
| Abdominal & Gastrointestinal | 921 | 30% |
| Hemorrhage & Bleeding | 742 | 25% |
| Shock & Circulatory | 365 | 12% |
| Neurological & Cognitive | 258 | 9% |
| Functional, Generalized & Constitutional | 193 | 6% |
| Obstetric & Gynecologic | 134 | 4% |
| Respiratory & Breathing | 79 | 3% |
| Cardiovascular | 48 | 2% |
| Social, Environmental & Administrative | 45 | 1% |
| Mental Health & Behavioral | 23 | 1% |
| Infectious, Febrile & Sepsis-Related | 13 | 0.4% |
| Endocrine & Metabolic | 10 | 0.3% |
| Genitourinary | 7 | 0.2% |
| Unknown, Ill-Defined & Unspecified | 188 | 6% |
Total: 3,026
Cause of Injury
The reported/suspected cause of the injury.
| Cause of Injury | Count | Percent |
|---|---|---|
| Motor Vehicle Crash (MVC) | 2,535 | 38% |
| Firearm | 1,890 | 29% |
| Contact with Sharp Object | 719 | 11% |
| Fall | 568 | 8.6% |
| Blunt Force | 196 | 3% |
| Self-Harm | 113 | 1.7% |
| Other Transport | 57 | 1% |
| Machinery / Industrial | 49 | 0.7% |
| Animal-Related | 24 | 0.4% |
| Burn / Fire / Heat | 10 | 0.2% |
| Other / Unspecified | 456 | 6.9% |
Total: 6,617
EMS clinicians may report multiple causes of injury.
Emergency Ground Ambulance Transfusions
Demographics and Urbanicity
Patient Age
| Age Group | Count | Percent |
|---|---|---|
| Child (0–14) | 184 | 2% |
| Teenager (15–19) | 609 | 6% |
| Young Adult (20–39) | 3,307 | 33% |
| Middle-aged Adult (40–64) | 3,101 | 31% |
| Older Adult (65+) | 2,552 | 26% |
| Unknown | 123 | 7% |
Total: 9,876
Urbanicity of Incident County
| Urbanicity | Count | Percent |
|---|---|---|
| Urban | 6,361 | 64% |
| Rural | 2,687 | 27% |
| Suburban | 435 | 4% |
| Frontier | 132 | 1% |
| Unknown | 267 | 3% |
Total: 9,876
Patient Race
| Race | Count | Percent |
|---|---|---|
| White | 4,428 | 45% |
| Black or African American | 2,648 | 27% |
| Hispanic or Latino | 1,551 | 16% |
| Asian | 157 | 2% |
| Multiple Races | 77 | 1% |
| American Indian or Alaska Native | 30 | 0.3% |
| Native Hawaiian or Other Pacific Islander | 19 | 0.2% |
| Unknown | 966 | 10% |
Total: 9,876
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