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Original research
Frequency of deployed emergency donor panel use prior to implementation of the low titre group O whole blood program
  1. Catherine Y Lin1,
  2. J D Hamm1,
  3. A D Fisher2,
  4. J A Rizzo1,3,
  5. J B Corley4,
  6. M D April1 and
  7. S G Schauer1,5,6
  1. 1Uniformed Services University, Bethesda, Maryland, USA
  2. 2Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
  3. 3Brooke Army Medical Center, Fort Sam Houston, Texas, USA
  4. 4Medical Capability Development Integration Directorate, Fort Sam Houston, Texas, USA
  5. 5Center for Combat and Battlefield (COMBAT) Research, University of Colorado School of Medicine, Aurora, Colorado, USA
  6. 6Departments of Anesthesiology and Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
  1. Correspondence to Dr S G Schauer, Uniformed Services University, Bethesda, MD 20814, USA; steven.g.schauer.mil{at}army.mil

Abstract

Introduction The US military has frequently used a ‘walking blood bank’, formally known as an ‘emergency donor panel’ (EDP) to obtain warm fresh whole blood (WFWB) which is then immediately transfused into the casualty. We describe the frequency of EDP activation by the US military.

Methods We analysed data from 2007 to 2015 within the Department of Defense Trauma Registry for US, Coalition and US contractor casualties that received at least 1 unit of blood product within the first 24 hours and described the frequency of WFWB use.

Results There were 3474 casualties that met inclusion, of which, 290 casualties (8%) required activation of the EDP. The highest proportion of EDP events was in 2014, whereas the highest number of EDP events was in 2011. Median injury severity scores were higher in the recipients, compared with non-EDP recipients (29 vs 20), as were proportions with serious injuries to the abdomen (43% vs 19%) and extremities (77% vs 65%). The median number of units of all blood products, except for packed red blood cells, was higher for WFWB recipients. Of the WFWB recipients, the median was 5 units (IQR 2–10) with a maximum documented 144 units. There were four documented cases of EDP recipients receiving >100 units of WFWB with only one surviving to hospital discharge. During the study period, there were a total of 3102 (3%) units of WFWB transfused among a total of 104 288 total units.

Conclusions We found nearly 1 in 11 casualties who received blood required activation of the EDP. Blood from the EDP accounted for 3% of all units transfused. These findings will enable future mission planning and medical training, especially for units with smaller, limited blood supplies. The lessons learned here can also enable mass casualty planning in civilian settings.

  • ACCIDENT & EMERGENCY MEDICINE
  • Adult intensive & critical care
  • ORTHOPAEDIC & TRAUMA SURGERY
  • Trauma management

Data availability statement

Data may be obtained from a third party and are not publicly available.

https://doi.org/10.1136/military-2023-002641

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    Data availability statement

    Data may be obtained from a third party and are not publicly available.

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    Footnotes

    • X @FisherAD1, @armyemdoc

    • Contributors CYL performed the literature search and drafted the initial manuscript. JH conceptualised the idea and provided critical revisions to the manuscript. ADF, JAR, JBC and MDA provided key subject matter expertise and performed critical revisions of the manuscript. SGS conceptualised the idea, performed the data analysis and is the overall principal investigator on the dataset from which this study was derived. All authors contributed substantially. CYL and SGS act as guarantors and accept overall responsibility for the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Disclaimer The views expressed in this article are those of the authors and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences, US Army Medical Department, Department of the Army, Department of Defense or the US Government.

    • Competing interests ADF, JAR, JBC, MDA and SGS have all received grants from the Department of Defense for other research.

    • Provenance and peer review Not commissioned; externally peer reviewed.