In Cold Blood: A Feasibility Study on Maintaining, Storing, and Transporting Cold Whole Blood by a Special Forces Unit

Transfusion of blood products at the point of injury is among the most critical interventions for trauma patients. Since WWI, the U.S. Military has been attempting to perfect the methods of transfusion to limit preventable deaths on the battlefield. While whole blood is now universally recognized as the premier blood product and a myriad of guidelines/protocols exist advocating for its use by SOF medics and providers far forward in the deployed setting, there is no cohesive guidance for blood product administration within the Continental United States (CONUS). This is despite recent data demonstrating that accidents are among the leading causes of death in non-deployed Servicemembers. Under current doctrine, only FDA-approved cold-stored whole blood should be used while in the U.S. With this in mind, our unit developed this feasibility study to determine whether a Special Forces Battalion would be able to maintain, store, and transport FDA-approved coldstored whole blood within appropriate temperature ranges in order to support blood transfusion at the point of injury and treat hemorrhagic shock in the CONUS training environment. This was a very small and simple study. However, it did demonstrate that maintaining appropriate temperature ranges is feasible, even as blood is transported to and from multiple sites of training. This is a critical first step in ensuring that appropriate blood products can be staged with and transported by our well-trained medics and providers supporting SOF training objectives within the U.S.