Improving the Emergency Whole Blood Program

The military has used the Emergency Whole Blood Program (EWBP) to treat combat casualties since World War 1 and it remains important in modern military campaigns. Despite frequent use, military medical providers receive little to no training on EWBP operations. The authors sought to improve the efficiency of the EWBP at a Forward Operating Base in southern Afghanistan during Operation Enduring Freedom 10-11 through the development of a prescreening program. A prescreened donor pool and registry were established by confirming blood type, rapid communicable disease testing, and completion and review of Defense Department (DD) form 572 before an emergency blood drive, during which prescreened donors were moved to the front of the line. Using prescreened donors, the mean time from EWBP activation to blood delivery to the operating room decreased from 43.3 (SD 4.4) to 26.7 minutes (SD 3.1) (p < 0.0004). The EWBP can be conducted more efficiently without compromising patient safety by implementing a robust prescreening program. Other improvements should include education of health care providers and commanders on prescreening and the EWBP. The use of fresh whole blood continues to be an important lifesaving resource in military medicine, and the Department of Defense should allocate resources to provide EWBP training and in-theater prescreening programs.