Shared by Steve Elmgren from a recent Georgia Prehospital Blood Coalition meeting discussion.

Published in the New England Journal of Medicine (May 2026), this multicenter randomized trial (the TOWAR study) compared prehospital transfusion with low-titer group O whole blood against blood components (plasma, red cells, or both) in trauma patients at risk of hemorrhagic shock. Across roughly 1,020 enrolled patients, 30-day mortality did not differ significantly between the two approaches, and outcomes were similar regardless of how long the whole blood had been in storage (up to 21 days).

Download the full study (PDF)