Brothers in Arms program improves trauma survival rates

February 18, 2019

The Brothers in Arms program is saving up to 100-200 patients a year with emergency whole blood transfusions at trauma sites, said one of the leaders of the program to The Blood & Tissue Center Foundation’s board of directors.

C.J. Winckler, M.D., Deputy Medical Director of the San Antonio Fire Department, spoke to the group at its quarterly board meeting on Feb. 11.


Brothers in Arms identifies certain donors’ blood as suitable for transfusion into any patient in an emergency and then makes that blood available on certain SAFD medical vehicles, medical helicopters and trauma centers. The blood is collected by the South Texas Blood & Tissue Center and tested by QualTex Laboratories.

It is the first and only large-scale program of its kind in the country, Winckler said.

“You want to live in San Antonio if you’re in a major accident,” he said. “We have the first EMS system that can provide whole blood to patients who need it.”

The value of Brothers in Arms has been evident in just the year it has been in place.

“There already has been a two-fold decrease in mortality in trauma cases,” Winckler said. “We’re saving 100-200 patients a year just from this one program.”


He mentioned several cases in which the transfusions saved lives in emergency situations. One dramatic situation involved a pregnant woman that began to bleed profusely.

“They gave her whole blood and she went from unresponsive with a blood pressure of 40 to responsive and talking,” Winckler said. “She went to the hospital and had an emergency C-section. Baby and mom are alive today because of Brothers in Arms.”


The transfusion of whole blood for traumatic blood loss was routine until the 1970s, when medical practice moved toward the use of blood components (red cells, platelets or plasma). The U.S. Army recently revived the idea of using whole blood in cases of traumatic injury, and it has spread to the civilian world in South Texas.

Winckler said one of the next steps for the program is to have a system available in case of a mass casualty event requiring large amounts of donations in a short period of time.