Introduction This paper describes the clinical governance, training, equipment and infrastructure developed to enable a UK Role 1 medical team to deliver forward transfusion in Southern Afghanistan. The aim was to explore the utility and feasibility of forward blood transfusion by a Role 1 medical team in an austere military environment.
Methods An audit of prospectively collected transfusion regulatory and cold chain data using standard-issue equipment and governance systems. TempIT tags were read before and after each mission to record blood storage temperature. Two years’ data were analysed to review the use of blood products, cold chain compliance and equipment issues.
Results Over 24 months, blood products were carried on over 1000 mission hours. Two clinical cases required transfusion and were successfully resuscitated. The team was able to correctly transport, store and deploy red cells and plasma on missions using standard Ministry of Defence (MOD) issue equipment. There were seven cold chain failures, all of which were addressed locally. Current cold chain and diagnostic equipment would require further optimisation for use at Role 1.
Conclusions An isolated Role 1 medical team can safely deliver blood transfusion on vehicle, helicopter or foot patrols. The transport and storage of blood created a large logistical burden for a relatively small clinical output. However, with further developments, this capability may have utility in contingency operations especially for isolated teams.
- ACCIDENT & EMERGENCY MEDICINE
- MEDICAL EDUCATION & TRAINING
- Received June 22, 2015.
- Revision received August 28, 2015.
- Accepted August 30, 2015.
- Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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HD has coauthored two papers dealing with similar topic: ▸ Gokhale SG, Scorer T, Doughty H. Freedom from frozen: the first British military use of lyophilised plasma in forward resuscitation. J R Army Med Corps 2016;162:63–5. ▸ Parker P, Nordmann G, Doughty H. Taking transfusion forward. J R Army Med Corps 2015;161:2–4.
Contributors NAM is the primary author. He planned the paper, collected and analysed the data and wrote the initial drafts. HD is the guarantor for overall content. She provided substantial advice and conducted critical revisions. SM provided specialist advice. PP provided advice and assisted with editing the final draft.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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