01-Are ‘walking blood banks’ coming to a field hospital near you?

<img src="/media/202408//1724856365.3497002.png" />Are ‘walking blood banks’coming to a field hospital near you?<img src="/media/202408//1724856365.356555.png" />Tuesday, May 2<img src="/media/202408//1724856365.362227.png" />A 75th Ranger Regiment SAW gunner, who is a qualified AdvancedRanger First Responder, conducts a blood transfusion from a universal donor to a Ranger in need of blood. (75th Ranger Regiment/Army via Reddit)HUNTSVILLE,Ala. — When the so-called “Golden Hour” is ticking away for a wounded soldier on the battlefield, every second counts.As does each drop of blood. Massive blood loss is a leading battlefield killer, staunched only by quick first aid and rapid replenishment.But as the Army restructures and prepares for a potential large-scalewar, the service’s medical planners recognize that getting patients tofully equipped hospitals in such a conflict may take days, and getting temperature-controlled blood products to the frontlines might be even more difficult.Army Times attended a discussion panel at an Association of the U.S. Army event a few weeks ago about the battle to move blood during the next conflict. Panelists argued that training conventional medics on extended casualty care will ensure blood transfusions start as close to the front as possible and buoy survival rates.Enter the walking blood bag, sometimes also called a walking blood bank.<img src="/media/202408//1724856365.418365.png" /><a href="https://apps.dtic.mil/sti/pdfs/ADA480272.pdf">The idea isn’t entirely new. In fact, according to a 2006 trauma studies paper, U.S. military doctors have used fresh donor blood in every major </a>conflict since the technique emerged during WorldWar I. Many military hospitals during the Global War on Terror tracked staffers’ blood types in case of mass casualty events that outpaced supply of other bloodproducts.<img src="/media/202408//1724856365.491657.jpeg" />Spc. Hayden Hutto, a medic assigned to Charlie Medical Company, 64th Brigade Support Battalion, 3rd Armored Brigade Combat Team, 4thInfantry Division,inserts a needle into U.S. Army Sgt. Kiana Lassalle, a medicalso assigned to Charlie Medical Company, during a walkingblood bank training at Skwierzyna, Poland, Aug. 10, 2022. (Sgt. Tara Fajardo Arteaga/Army)But the practice is moving closer to the frontline.In recent years, the special operations community pioneered person-to-person whole blood transfusions during combat, a 10-minute process in which a soldier donates blood into a transfer bag and then returns tothe fight while it’s administered to their wounded comrade. The 75th Ranger Regiment, the Army’s toplight infantry unit, said in <a href="https://www.army.mil/article/231597/under_heavy_fire_ranger_medics_save_lives_with_blood_donations">a release</a> that such transfusions saved soldiers wounded in Afghanistan during summer 2019.The panelists want the conventional Army to catch up and push toward the front. While the <a href="https://www.marines.mil/News/News-Display/Article/2489777/valkyrie-emergency-fresh-whole-blood-transfusion-enhances-15th-meu-medical-capa/">Marine Corps</a> and some <a href="https://www.army.mil/article/225327/walking_blood_bank_can_save_lives_on_the_battlefield">elements of the Army</a> have already started training the concept, one of the Army’s top doctorswants the practice and its training standardized and fielded across the force.“We have doctrine that talks about walking blood banks,” said Brig. Gen. Mark Thompson, a soon-retiring Army Medical Command logisticsplanner. “We do not have doctrine that talks about walking blood banks far forward.”Col. Jason Corley, who helps manage and integrate new blood product technologies, said the service’s Medical Center of Excellence is working “to develop standardized training tasks, lists and methods ofinstruction” in addition to deciding which Army career fields — such as combat medics — will be tasked to learn the technique.<img src="/media/202408//1724856365.52226.jpeg" />A U.S. Soldier assigned to 64th Brigade Support Battalion, 3rd Armored Brigade Combat Team, 4th Infantry Division, holds a bloodtype testing card during a walking blood bank training at Skwierzyna, Poland, Aug. 10, 2022. (Sgt. Tara Fajardo Arteaga/Army)Thompson said bringing such practices forward to Role 1 aid stations, which provide initial casualty treatment before shipping more serious cases to surgical teams, can help keep patients alive longer on abattlefield where air evacuation may someday be impossible.The capability integrator, Corley, noted the special operationscommunity’s work provides “a tremendous amount of lessons learned” to guide how the conventional force will embrace walking blood banks.But both he and Thompson warned that the practice won’t be a cure-all, nor will it always work.The general highlighted the issue of “scale and supply,” arguing that for conventional forces “the size of the casualty event is likely muchlarger.”Corley cautioned that personnel might not always have the sterilesupplies needed to pull it off, nor will units always have enough donors with a compatible bloodtype. But he argued that history shows thepractice will be a key part of the next big war.“We’ve learned in past conflicts that walking blood bank is absolutely a critical capability,” he said. “[I] think it will help us to overcomecontested logistics ... and we need to ensure that all of our medical providers across all roles of care can implement it.Davis Winkie is a senior reporter covering the Army. He focuses oninvestigations, personnel concerns and military justice. Davis, also aGuard veteran, was a finalist in the 2023 Livingston Awards for his work with The Texas Tribune investigating the National Guard's bordermissions. 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