A prospective assessment of the time required to obtain one unit of fresh whole blood by civilian phlebotomists and Army laboratory technicians (68 K)

Abstract

Background Resuscitation with blood products improves survival after major hemorrhage. Blood product administration at or near the point‐of‐injury (POI) amplifies this benefit. Size, weight, and cold‐chain management challenges all limit the amount of blood medics can carry. Warm fresh whole blood (WFWB) transfusions from a pre‐screened donor within the unit represent an alternative source of blood at the POI. We measured the time required for civilian and Army technicians performing phlebotomy frequently to obtain one unit of blood to serve as a goal metric for combat medics being trained in this skill. Methods We gathered demographic and experience data along with proportion of first intravenous cannulation attempt success, time to blood flow initiated, and time to unit draw complete. Results We prospectively enrolled 12 civilian phlebotomy technicians and 10 Army laboratory technicians performing whole blood collections on 50 and 68 donors respectively. The mean time from setup to needle insertion was 3.7 min for civilians versus 4.2 min for Army technicians. The mean time from blood flowing to the bag being full was 10.7 min versus 8.4 min for civilians versus Army technicians respectively. The mean bag weights were 514 g versus 522 g. First‐pass intravenous cannulation success was 96% versus 98% respectively. Conclusions We found a high first intravenous cannulation attempt success among both the civilian and Army technicians. Medians times were <5 min to obtain venipuncture and <11 min to obtain one unit. These findings provide time‐based benchmarks for potential use during transfusion training among military medics.

Blood consumption in the Role 2 setting: A Department of Defense Trauma Registry analysis

“…Conversely, we need strategies to identify those that are unsalvageable 22 . These strategies should encompass a range of measures, such as improving the accuracy of activating emergency donor panels, also known as walking blood banks 23 . Additionally, it is crucial to establish the logistical framework needed for maintaining cold chain storage on a larger scale.…”

“…Explosives were the predominant mechanism of injury among both groups. The composite injury severity score was 5 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11) in non-recipients and 16 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) in recipients. Among the blood recipients, there was a higher proportion of serious injuries to all body regions.…”

“…22 These strategies should encompass a range of measures, such as improving the accuracy of activating emergency donor panels, also known as walking blood banks. 23 Additionally, it is crucial to establish the logistical framework needed for maintaining cold chain storage on a larger scale. By ensuring an adequate supply of whole blood, and by effectively managing this supply, providers at all echelons of care will be better prepared to improve the survival chances of patients suffering from hemorrhage.…”