Low‐titer group O whole blood in military ground ambulances: Lessons from the Israel Defense Forces initial experience

Author:

Talmy Tomer12ORCID,Malkin Michael12ORCID,Esterson Akiva1,Yazer Mark H.3ORCID,Sebbag Anat1,Shina Avi12,Shinar Eilat4ORCID,Glassberg Elon156,Gendler Sami1ORCID,Almog Ofer12ORCID

Affiliation:

1. Israel Defense Forces Medical Corps Ramat Gan Israel

2. Department of Military Medicine, Faculty of Medicine Hebrew University Jerusalem Israel

3. Department of Pathology University of Pittsburgh Pittsburgh Pennsylvania USA

4. Magen David Adom National Blood Services Ramat Gan Israel

5. The Azrieli Faculty of Medicine Bar‐Ilan University Safed Israel

6. The Uniformed Services University of the Health Sciences Bethesda Maryland USA

Abstract

AbstractBackgroundCold‐stored low‐titer group O whole blood (LTOWB) has become increasingly utilised in both prehospital and in‐hospital settings for resuscitation of traumatic haemorrhage. However, implementing the use of LTOWB to ground medical teams has been limited due to logistic challenges.MethodsIn 2022, the Israel Defense Forces (IDF) started using LTOWB in ambulances for the first time in Israel. This report details the initial experience of this rollout and presents a case‐series of the first patients treated with LTOWB.ResultsBetween January–December 2022, seven trauma patients received LTOWB administered by ground IDF intensive care ambulances after presenting with profound shock. Median time from injury to administration of LTOWB was 35 min. All patients had evidence of severe bleeding upon hospital arrival with six undergoing damage control laparotomy and all but one surviving to discharge.ConclusionsThe implementation of LTOWB in ground medical units is in its early stages, but continued experience may demonstrate its feasibility, safety, and effectiveness in the prehospital setting. Further research is necessary to fully understand the indications, methodology, and benefits of LTOWB in resuscitating severely injured trauma patients in this setting.

Publisher

Wiley

Subject

Hematology

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