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Joint Trauma System, Defense Committee on Trauma, and Armed Services Blood Program consensus statement on whole blood
Author(s) -
Shackelford Stacy A.,
Gurney Jennifer M.,
Taylor Audra L.,
Keenan Sean,
Corley Jason B.,
Cunningham Cord W.,
Drew Brendon G.,
Jensen Shane D.,
Kotwal Russ S.,
Montgomery Harold R.,
Nance Erika T.,
Remley Michael A.,
Cap Andrew P.
Publication year - 2021
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.16454
Subject(s) - medicine , whole blood , resuscitation , blood transfusion , blood component , blood product , medical emergency , emergency medicine , blood donations , hemorrhagic shock , packed red blood cells , intensive care medicine , emergency medical services , military personnel , surgery , political science , law
Hemorrhage is the most common mechanism of death in battlefield casualties with potentially survivable injuries. There is evidence that early blood product transfusion saves lives among combat casualties. When compared to component therapy, fresh whole blood transfusion improves outcomes in military settings. Cold‐stored whole blood also improves outcomes in trauma patients. Whole blood has the advantage of providing red cells, plasma, and platelets together in a single unit, which simplifies and speeds the process of resuscitation, particularly in austere environments. The Joint Trauma System, the Defense Committee on Trauma, and the Armed Services Blood Program endorse the following: (1) whole blood should be used to treat hemorrhagic shock; (2) low‐titer group O whole blood is the resuscitation product of choice for the treatment of hemorrhagic shock for all casualties at all roles of care; (3) whole blood should be available within 30 min of casualty wounding, on all medical evacuation platforms, and at all resuscitation and surgical team locations; (4) when whole blood is not available, component therapy should be available within 30 min of casualty wounding; (5) all prehospital medical providers should be trained and logistically supported to screen donors, collect fresh whole blood from designated donors, transfuse blood products, recognize and treat transfusion reactions, and complete the minimum documentation requirements; (6) all deploying military personnel should undergo walking blood bank prescreen laboratory testing for transfusion transmitted disease immediately prior to deployment. Those who are blood group O should undergo anti‐A/anti‐B antibody titer testing.