U.S. Marines implement Emergency Transfusion Program in Middle East

Story by Capt. Joshua Hays, 13th Marine Expeditionary Unit   

A U.S. Marine Corps infantry battalion implemented an emergency blood transfusion program while deployed to the Middle East.

Marines and Sailors from 2nd Battalion, 5th Marine Regiment, assigned to Special Purpose Marine Air-Ground Task Force – Crisis Response – Central Command, standardized an emergency blood transfusion program across the ground combat element. The combat causality technique allows the battalion to have a viable and pre-screened donor pool for emergency situations.

The Emergency Fresh Whole Blood (EFWB) program, originally utilized by members of the special operations community, allows pre-screened low titer group (type) O whole blood (LTOWB) donors the ability to deliver life-saving treatment at the point of injury to increase the chance of survival while awaiting transit to the next echelon of care. A similar U.S. Army program, known as the “Ranger O Low Titer (ROLO) Whole Blood Program,” was used for the first known time in Afghanistan earlier this year.

According to a Department of Defense study, from 2001-2011, during Operation Enduring Freedom and Operation Iraqi Freedom, there were approximately 887 deaths resulting from massive blood loss that were potentially survivable had additional blood been available before arrival at an expeditionary surgical suite. By enabling multiple on-the-spot donors, blood can be safely transfused from a mobile donor to a critical patient during transport or from a location shielded from hazard.

The force surgeon and emergency physician, U.S. Navy Lt. Cmdr. Sean Nardi, noted that by pre-identifying LTOWB donors, Marines and Sailors can quickly find a donor and begin the EFWB transfusion.

“Our ground combat element has really spearheaded this program and brought it to the entire command,” said Nardi. “We, along with champions of the program stateside, are currently validating training plans and standard operating procedures in order to truly make it a program of record for conventional forces throughout the service.”

Before a deployment, each consenting Marine or Sailor with group O blood is screened. This screening confirms their blood type, titer levels, and evaluates for transfusion transmitted diseases. Once the screening is complete, and if the service member is deemed to be a LTOWB donor, the service member is provided a donor identification card to keep on their person at all times.

“The EFWB program gives the ground combat element a capability that it hasn’t had in the past,” said U.S. Navy Lt. Lauren Murray, the infantry battalion’s surgeon. “Having the ability to resuscitate casualties with whole blood at the point of injury gives the ground combat element the ability to decrease mortality rates in situations where we are not able to evacuate casualties within the first hour after injury.”

Aside from the physical lifesaving aspect of the emergency transfusion, infantry unit’s commanding officer, Lt. Col. Isaac Moore, believes there is a stronger psychological impact and benefit it brings to Marines forward-deployed.

“Marines are always there for each other, and [the EFWB program] is one more way they demonstrate that,” said Moore. “One individual literally giving his own blood to save a fellow Marine increases cohesion. In a sense, the unit can use the healthy life-blood of one Marine to sustain another. That’s a pretty powerful idea that makes a unit incredibly resilient.”

Each kit weights less-than one pound and costs approximately $135 U.S. dollars, which includes a blood collection bag, needles, filtered surgical tubing and equipment to maintain cleanliness. Each qualified Sailor can carry two kits on top of their standard gear and equipment.

Medical professionals and Marines currently assigned to SPMAGTF-CR-CC intend to keep the EFWB program moving forward with the drive to make the life-saving procedure and cost effective equipment standard across the service.

SPMAGTF-CR-CC is capable of employing aviation, ground, and logistics forces across the U.S. Central Command’s Area of Responsibility at a moment’s notice.