Does anyone know of a standard or requirement that states there has to be blood available in a free standing emergency dept.?

Not to my knowledge. Indeed, I don't believe free standing EDs should have blood available,  unless there is no hospital within 20-30 miles and no helicopters are available for transport.  I would want patients with life threatening bleeding or anemia to be taken only to a facility with on-site surgical facilities, surgeons,  interventional radiology, etc. which are generally not available in free standing EDs.  In other words, a fully staffed hospital.  I would advocate taking such critically ill patients to the nearest level 1 or 2 trauma center, whenever one can, and bypass the free standing ED.  

Edited May 21, 20187 yr by Neil Blumberg

I would think you have to look at individual requirements as regulated by the state it is in.  Such a facility is (at the least)  required to have agreements with a full-service hospital for transfers after stabilization.

Scott

The free standing surgery center in our small city wanted a agreement for availability of blood products in case of an emergency. I assumed that it was a regulatory requirement of either the state or some other agency that has oversight of such a facility. We have never been asked to provide blood and I don't expect that we ever will be. It is faster to get the patient loaded into an ambulance and into our ED than it would be to request blood, come and get it, return to the surgery center and transfuse. I doubt they have the supplies to start an infusion. The surgeons and anesthesiologist there wouldn't want to be responsible for transfusion with uncrossmatched blood, so they aren't going to take any chances by keeping a patient that needs transfusion. I think they were just checking a box on a checklist. I would hope that a free standing ED would not be receiving major trauma cases, but that would depend on how they are set up.