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The thin red line: Blood planning factors and the enduring need for a robust military blood system to support combat
Jennifer M Gurney1, Andrew P Cap, John B Holcomb
1From the Joint Trauma System (J.M.G., J.-M.V.G., J.D.S.), Defense Health Agency, Joint Base San Antonio-Fort, Sam Houston; US Army Institute of Surgical Research (J.M.G., A.P.C.), Fort Sam Houston, San Antonio, Texas; Department of Surgery, Trauma and Acute Care University of Alabama Medical Center (J.B.H.), Birmingham, Alabama; The Geneva Foundation at U.S. Army Institute of Surgical Research (A.M.S.), 3698 Chambers Pass, Joint Base San Antonio-Fort Sam Houston, Texas; Department of Surgery (M.D.T.), Naval Medical Center, San Diego; 1st Medical Battalion (M.D.T.), 1st Marine Logistics Group, Camp Pendleton, California; Director of Combat Casualty Care Research Program (T.M.P.), Medical Research and Development Command, Ft. Deetrick, MD; Armed Service Blood Program (C.D., M.A.S., L.E.R.), Falls Church, Virginia; Medical Capability Development Integration Directorate (J.B.C.), JBSA Fort Sam Houston, Texas; Donald D. Trunkey Center for Civilian and Combat Casualty Care (M.A.S.), Oregon Health & Science University, Portland, Oregon; Trauma and Acute Care Surgery, Faculty of Medicine (A.B.), St. Michael's Hospital, University of Toronto, Toronto; Canadian Forces Health Services (A.B.), Ottawa, Ontario, Canada; Defense Health Agency (S.A.S.), US Air Force Academy (S.A.S.), Colorado Springs, Colorado; and Department of Surgery (M.J.M.), Keck School of Medicine, University of Southern California, Los Angelos, California.
Battlefield lessons learned are forgotten; the current name for this is the Walker Dip. Blood transfusion and the need for a Department of Defense Blood Program are lessons that have cycled through being learned during wartime, forgotten, and then relearned during the next war. The military will always need a blood program to support combat and contingency operations. Also, blood supply to the battlefield has planning factors that have been consistent over a century. In 2024, it is imperative that we codify these lessons learned. The linchpins of modern combat casualty care are optimal prehospital care, early whole blood transfusion, and forward surgical care. This current opinion comprised of authors from all three military Services, the Joint Trauma System, the Armed Services Blood Program, blood SMEs and the CCC Research Program discuss two vital necessities for a successful military trauma system: (1) the need for an Armed Services Blood Program and (2) Planning factors for current and future deployed military ere is no effective care for wounded soldiers, and by extension there is no effective military medicine.
Battlefield lessons learned are forgotten; the current name for this is the Walker Dip. Blood transfusion and the need for a Department of Defense Blood Program are lessons that have cycled through being learned during wartime, forgotten, and then relearned during the next war. The military will always need a blood program to support combat and contingency operations. Also, blood supply to the battlefield has planning factors that have been consistent over a century. In 2024, it is imperative that we codify these lessons learned. The linchpins of modern combat casualty care are optimal prehospital care, early whole blood transfusion, and forward surgical care. This current opinion comprised of authors from all three military Services, the Joint Trauma System, the Armed Services Blood Program, blood SMEs and the CCC Research Program discuss two vital necessities for a successful military trauma system: (1) the need for an Armed Services Blood Program and (2) Planning factors for current and future deployed military ere is no effective care for wounded soldiers, and by extension there is no effective military medicine.
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