(1572) Frequency of Deployed Emergency Donor Panel Use in the Deployed Trauma Setting

Introduction: During recent conflicts, the US military has seen unprecedented survival rates, some of which is attributed to the aggressive use of blood products. In these settings, the number of casualties requiring blood can outpace resources. The US military has frequently used a “walking blood bank”, more formally known as an “emergency donor panel” (EDP) to obtain warm, fresh, whole blood (WFWB) which will be transfused into the casualty. This concept is also being expanded into the civilian setting, such as mass casualty incidents. We sought to describe the frequency of EDP activation by the US military during the recent conflicts.

Methods: We analyzed data from 2007-2015 within the Department of Defense Trauma Registry (DODTR) for US and Coalition casualties that received at least one unit blood product within the first 24 hours and describe the frequency of WFWB use.

Results: There were 3474 casualties that met inclusion, of which, 290 casualties (8%) required activation of the EDP. The highest proportion of EDP events was in 2014, whereas the highest number of EDP events was in 2011. Median injury severity scores were higher in the recipients, compared to non EDP recipients (29 versus 20), as were proportions with serious injuries to the abdomen (43% versus 19%) and extremities (77% versus 65%). Median number of units of all blood products, except for packed RBCs, were higher for WFWB recipients. Of the WFWB recipients, the median was 5 units (IQR 2-10) with a maximum documented 144 units. The most blood product a recipient received was 331 units of PRBCs, 48 units of platelets, 155 units of cryoprecipitate, and 358 units of plasma and they did not survive to hospital discharge. There were 4 documented cases of EDP recipients receiving >100 units of WFWB with only one surviving to hospital discharge.

Conclusions: We found 1 in 11 casualties who received blood required activation of the EDP. These findings will enable future mission planning and medical training, especially for units with smaller, limited blood supplies. The lessons learned here can enable mass casualty planning in the civilian setting.