Early blood transfusion for a trauma patient experiencing a major haemorrhage significantly improves their chance of survival before they reach hospital. While providing out-of-hospital blood transfusions can delay the arrival of the patient to hospital, starting the transfusion earlier outweighs this risks in most cases. There is therefore an argument that paramedics should be able to administer blood products to severely injured patients as this would improve outcomes and survival. While minimal extra equipment would be needed, the cost, storage and waste of blood need to be considered. Through the findings of a review, this paper discusses the feasibility and practicalities of paramedics providing out-of-hospital blood transfusion and the implications for training and policies to mitigate cost and blood waste.