Civilian walking blood bank emergency preparedness plan
Corresponding Author
John B. Holcomb
Center for Injury Science, Division of Acute Care Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
Correspondence
John B. Holcomb, Center for Injury Science, University of Alabama at Birmingham, 1922 7th Ave S, Birmingham, AL 35294, USA.
Email: [email protected]
Search for more papers by this authorPhilip C. Spinella
Division of Critical Care, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
Search for more papers by this authorTorunn Oveland Apelseth
Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
Norwegian Armed Forces Medical Service, Sessvollmoen, Norway
Search for more papers by this authorFrank K. Butler
Uniformed Services University, Bethesda, Maryland, USA
Search for more papers by this authorJeremy W. Cannon
Division of Traumatology, Surgical Critical Care & Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAndrew P. Cap
Uniformed Services University, Bethesda, Maryland, USA
US Army Institute of Surgical Research, San Antonio, Texas, USA
Ft Sam Houston, San Antonio, Texas, USA
Search for more papers by this authorJason B. Corley
Army Blood Program, US Army Medical Command, JBSA - Fort Sam Houston, San Antonio, Texas, USA
Search for more papers by this authorHeidi Doughty
Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK
Search for more papers by this authorSara F. Goldkind
Goldkind Consulting, L.L.C., Chevy Chase, Maryland, USA
Search for more papers by this authorJennifer M. Gurney
US Army Institute of Surgical Research, San Antonio, Texas, USA
Search for more papers by this authorMary J. Homer
Division of Chemical, Biological, Radiological, and Nuclear Countermeasures, Biomedical Advanced Research and Development Authority (BARDA), Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, District of Columbia, USA
Search for more papers by this authorSarah J. Ilstrup
Department of Laboratory Medicine and Pathology, Intermountain Medical Center, Salt Lake City, Utah, USA
Search for more papers by this authorJan O. Jansen
Division of Acute Care Surgery; and Director, Center for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
Search for more papers by this authorDonald H. Jenkins
Division of Trauma and Emergency Surgery, UT Health, San Antonio, Texas, USA
Search for more papers by this authorMarisa B. Marques
Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
Search for more papers by this authorEugene E. Moore
Shock Trauma Center at Denver Health, Department of Surgery, University of Colorado Denver, Denver, Colorado, USA
Search for more papers by this authorPaul M. Ness
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Search for more papers by this authorKevin C. O'Connor
George Washington University School of Medicine and Health Sciences, Medical Faculty Associates, Washington, District of Columbia, USA
Search for more papers by this authorMartin A. Schreiber
Oregon Health & Science University, Portland, Oregon, USA
Search for more papers by this authorSteve Sloan
Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorGeir Strandenes
Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
Department of War Surgery and Emergency Medicine, Norwegian Armed Forces Medical Services, Oslo, Norway
Search for more papers by this authorJames R. Stubbs
Transfusion Medicine, Mayo Clinic, Rochester, Minnesota, USA
Search for more papers by this authorAudra L. Taylor
Armed Services Blood Program, Defense Health Agency, Falls Church, Virginia, USA
Search for more papers by this authorKevin R. Ward
George Washington University School of Medicine and Health Sciences, Medical Faculty Associates, Washington, District of Columbia, USA
Search for more papers by this authorElizabeth Waltman
BioBridge Global, Inc., San Antonio, Texas, USA
South Texas Blood & Tissue Center, San Antonio, Texas, USA
Search for more papers by this authorMark Yazer
University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Tel Aviv University, Tel Aviv, Israel
University of Southern Denmark, Odense, Denmark
Search for more papers by this authorCorresponding Author
John B. Holcomb
Center for Injury Science, Division of Acute Care Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
Correspondence
John B. Holcomb, Center for Injury Science, University of Alabama at Birmingham, 1922 7th Ave S, Birmingham, AL 35294, USA.
Email: [email protected]
Search for more papers by this authorPhilip C. Spinella
Division of Critical Care, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
Search for more papers by this authorTorunn Oveland Apelseth
Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
Norwegian Armed Forces Medical Service, Sessvollmoen, Norway
Search for more papers by this authorFrank K. Butler
Uniformed Services University, Bethesda, Maryland, USA
Search for more papers by this authorJeremy W. Cannon
Division of Traumatology, Surgical Critical Care & Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAndrew P. Cap
Uniformed Services University, Bethesda, Maryland, USA
US Army Institute of Surgical Research, San Antonio, Texas, USA
Ft Sam Houston, San Antonio, Texas, USA
Search for more papers by this authorJason B. Corley
Army Blood Program, US Army Medical Command, JBSA - Fort Sam Houston, San Antonio, Texas, USA
Search for more papers by this authorHeidi Doughty
Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK
Search for more papers by this authorSara F. Goldkind
Goldkind Consulting, L.L.C., Chevy Chase, Maryland, USA
Search for more papers by this authorJennifer M. Gurney
US Army Institute of Surgical Research, San Antonio, Texas, USA
Search for more papers by this authorMary J. Homer
Division of Chemical, Biological, Radiological, and Nuclear Countermeasures, Biomedical Advanced Research and Development Authority (BARDA), Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, District of Columbia, USA
Search for more papers by this authorSarah J. Ilstrup
Department of Laboratory Medicine and Pathology, Intermountain Medical Center, Salt Lake City, Utah, USA
Search for more papers by this authorJan O. Jansen
Division of Acute Care Surgery; and Director, Center for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
Search for more papers by this authorDonald H. Jenkins
Division of Trauma and Emergency Surgery, UT Health, San Antonio, Texas, USA
Search for more papers by this authorMarisa B. Marques
Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
Search for more papers by this authorEugene E. Moore
Shock Trauma Center at Denver Health, Department of Surgery, University of Colorado Denver, Denver, Colorado, USA
Search for more papers by this authorPaul M. Ness
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Search for more papers by this authorKevin C. O'Connor
George Washington University School of Medicine and Health Sciences, Medical Faculty Associates, Washington, District of Columbia, USA
Search for more papers by this authorMartin A. Schreiber
Oregon Health & Science University, Portland, Oregon, USA
Search for more papers by this authorSteve Sloan
Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorGeir Strandenes
Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
Department of War Surgery and Emergency Medicine, Norwegian Armed Forces Medical Services, Oslo, Norway
Search for more papers by this authorJames R. Stubbs
Transfusion Medicine, Mayo Clinic, Rochester, Minnesota, USA
Search for more papers by this authorAudra L. Taylor
Armed Services Blood Program, Defense Health Agency, Falls Church, Virginia, USA
Search for more papers by this authorKevin R. Ward
George Washington University School of Medicine and Health Sciences, Medical Faculty Associates, Washington, District of Columbia, USA
Search for more papers by this authorElizabeth Waltman
BioBridge Global, Inc., San Antonio, Texas, USA
South Texas Blood & Tissue Center, San Antonio, Texas, USA
Search for more papers by this authorMark Yazer
University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Tel Aviv University, Tel Aviv, Israel
University of Southern Denmark, Odense, Denmark
Search for more papers by this authorAbstract
Background
The current global pandemic has created unprecedented challenges in the blood supply network. Given the recent shortages, there must be a civilian plan for massively bleeding patients when there are no blood products on the shelf. Recognizing that the time to death in bleeding patients is less than 2 h, timely resupply from unaffected locations is not possible. One solution is to transfuse emergency untested whole blood (EUWB), similar to the extensive military experience fine-tuned over the last 19 years. While this concept is anathema in current civilian transfusion practice, it seems prudent to have a vetted plan in place.
Methods and Materials
During the early stages of the 2020 global pandemic, a multidisciplinary and international group of clinicians with broad experience in transfusion medicine communicated routinely. The result is a planning document that provides both background information and a high-level guide on how to emergently deliver EUWB for patients who would otherwise die of hemorrhage.
Results and Conclusions
Similar plans have been utilized in remote locations, both on the battlefield and in civilian practice. The proposed recommendations are designed to provide high-level guidance for experienced blood bankers, transfusion experts, clinicians, and health authorities. Like with all emergency preparedness, it is always better to have a well-thought-out and trained plan in place, rather than trying to develop a hasty plan in the midst of a disaster. We need to prevent the potential for empty shelves and bleeding patients dying for lack of blood.
CONFLICT OF INTEREST
PCS is a consultant for Hemanext, Cerus, Entegrion, and Secure Transfusion Services. JOJ is a consultant for CSL Behring. MAS is a consultant for Haemonetics and CSL Behring. KRW is a LTC in the U.S. Army Reserve MC. He has several technologies and patents through the University of Michigan regarding hemostasis. He receives research funding from the Department of Defense. MY has received honoraria from Terumo, Haemonetics, Cook Biomedical, and Grifols. He has received paid travel from Terumo and Cerus. He is on the advisory boards for New Health Sciences, Aktivax, Macopharma, Octapharma, and Verax Biomedical. JBH is a co-founder and on the Board of Directors of Decisio Health, on the Board of Directors of QinFlow and Zibrio, a Co-inventor of the Junctional Emergency Tourniquet Tool, an adviser to CSL, Safeguard, Arsenal Medical, Cellphire, Spectrum, and PotentiaMetrics. All other authors have disclosed no conflicts of interest.
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