Prisma Health ambulances are first in state to transfuse blood during ambulance transport

GREENVILLE, S.C. – Debi Liveright – and Prisma Health Ambulance Service – made history when the Seneca woman became the first patient in the state to receive a blood transfusion while being transported by ambulance to a hospital.

“If it hadn’t been for the paramedics, I would not be here today,” said Liveright, a 59-year-old grandmother of 11. “I’d definitely be taking a dirt nap.”

Prisma Health Ambulance Service is the Upstate’s only ambulance service authorized by the S.C. Department of Health and Environmental Control (DHEC) to provide blood transfusions while patients are under paramedic care and en route to hospital via ambulance.

Prisma Health administered its first unit of blood during ambulance transport on Feb. 18, said Aaron Dix, executive director of Prisma Health’s emergency medical services.

“We’re thrilled to be able to offer this leading-edge treatment for the patients we transport,” said Dix. “Very few ambulance services in the nation offer this. We’re proud that we have the expertise and training to provide this for patients for whom minutes or even seconds can make a huge difference in their outcomes.”

Quicker access is especially critical for those patients with internal bleeding where it’s not possible to stop active hemorrhage before surgery, he said.

“For patients who suffer severe trauma and blood loss, also known as hemorrhagic shock, timely resuscitation with blood products is crucial to improving survival,” said emergency medicine physician Elizabeth Mannion, MD. She is medical director for the Prisma Health Ambulance Service and the physician overseeing the pilot program. “While this is a widely accepted practice once a patient arrives at a trauma center, it has not commonly been available for ground ambulances in the prehospital setting.”

Prisma Health—Upstate has four ambulances that now carry blood – two in Greenville, one in Oconee and one in Easley. Each ambulance carries two units of fresh frozen plasma and two units of packed red blood cells which are swapped out every 24 hours at each hospital’s blood bank, Each ambulance also now carries specialized warmers that can heat the blood from 38 degrees to patient-ready 100 degrees in only 24 seconds.

The blood products are kept in special medical transport cases that keep the blood chilled until ready to use; the high-tech cases include alarms that sound if the blood falls out of the specified range.

To perform infusions and use the specialized equipment, the paramedics working on the ambulance all underwent more than a dozen hours of detailed additional training.

According to the South Carolina Department of Health and Environmental Control (DHEC), Colleton County Fire-Rescue is the only other ambulance service in South Carolina to offer blood service.

Based on previous patient needs, Prisma Health expects to provide on-board transfusions a minimum of 200 times in the coming year. Prisma Health paramedics have already used it four times since getting state approval earlier in the month.

First-patient Liveright hadn’t been feeling well since Saturday, Feb. 15, but had attributed it to low-blood sugar or the joyful stress of a family wedding. Within three days, however, she was vomiting up a black tarry substance and unable to walk. Her husband called 911. Paramedics with Prisma Health were dispatched to her home. The team assessed her and began the transfusion en route to Prisma Health Oconee Memorial Hospital. Because her blood pressure was so critically low, two units were given in the field and another two units at the hospital.

Liveright, who was diagnosed with bleeding ulcers at the hospital, said the quick in-the-field intervention saved her life. “I had basically flat-lined. It’s a miracle I’m still here. I guess the Lord still has more work for me to do.”

Said Dix, “We hope that other ambulance services in the state will see the tremendous impact of this program and pursue their own additional certification and training in order to provide this service to their patients. Because blood administration can have such a tremendous impact on patient outcomes, we will make this service available to all surrounding communities in the meantime upon request.”

Consent will be obtained from the patient or next of kin prior to any transfusion, Dix said.

About Prisma Health

Prisma Health is a not-for-profit health company and South Carolina’s largest private employer. With nearly 32,000 team members, 18 hospitals, 2,984 beds, and more than 300 physician practice sites, Prisma Health serves more than 1.2 million unique patients annually. Its goal is to improve the health of all South Carolinians by enhancing clinical quality, the patient experience and access to affordable care, as well as conducting clinical research and training the next generation of medical professionals. The organization was formed in late 2017 when Greenville Health System and Palmetto Health came together, officially becoming Prisma Health in January 2019.For more information, visit


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