Small Arms Marksmanship Accuracy Surrounding Fresh Whole Blood Donation in the U.S. Army Conventional Soldier

Whole blood is commonly used for casualty resuscitation in the prehospital setting. According to the 2021 Committee on Tactical Combat Casualty Care guidelines, whole blood is the preferred fluid for resuscitating casualties with signs of hemorrhagic shock, followed by fresh whole blood (FWB). There is limited literature on soldiers' physical and cognitive performance following donation, particularly regarding their small marksmanship accuracy immediately after 1 unit of FWB donation. Current research on marksmanship accuracy post-FWB donation among military personnel is limited to the Norwegian and Israeli militaries. The lack of Department of Defense clinical practice guidelines restricting soldiers' duties after FWB donation highlights the paucity of data. This study evaluates the effects of FWB donation on U.S. Army conventional soldiers' small marksmanship accuracy and provides quantifiable data for future U.S. Army post-FWB donation guidelines.

This was a prospective, controlled trial assessing small arms marksmanship accuracy pre- and post-FWB donation with a convenience sample of conventional U.S. Army conventional soldiers, using an indoor Electronic Skill Trainer (EST) simulator. The primary outcome assessed for a difference in small arms marksmanship accuracy following FWB donation. Participants served as their own controls, with baseline marksmanship accuracy testing performed before FWB donation and again immediately after. Secondary outcomes were the participants' pre- and post-FWB donation self-efficacy scores.

Sixteen participants completed small arms marksmanship accuracy testing pre- and post-FWB donation. We found no significant difference in small arms marksmanship accuracy following FWB donation (24.69 vs. 26.32, P = .38). Similarly, we evaluated small arms marksmanship accuracy self-efficacy via a Bandura Scale and found no significant difference between pre-and post-FWB donation (86.25 vs. 85.63, P = .67).

The accuracy of U.S. Army conventional soldiers small arms marksmanship was not significantly different after donating 1 unit of FWB. This study provides data on post-FWB donation marksmanship accuracy, which could inform future guidelines for soldiers returning to duty after donating 1 unit of FWB blood. Larger, comparative studies need to be performed to further investigate soldiers' post-FWB donation marksmanship accuracy.