In-flight transfusions saving lives on the battlefield
February 1, 2013
KABUL — Administering transfusions in the dark, noise and chaos of a moving Black Hawk helicopter is a tall order, but a trial program in Afghanistan teaching medics to do just that is shaving crucial minutes off the time it takes to get the most critically injured troops life-saving care in-flight.
So-called “vampire” missions, where medical evacuation choppers carry blood, started flying this summer, and military officials say the in-flight transfusions have already saved lives.
Before the program began in June, only the specialized Air Force “Pedro” rescue helicopters carried blood, meaning most wounded troops could not get transfusions until arriving at a hospital.
“Most of the people we see who die, it’s really because they don’t have blood in their body,” said Army Capt. Deanna Klesney, a flight surgeon who is overseeing the training. “A lot of people die en route.”
Roadside bombs remain the biggest killer of U.S. troops, and many injured in such attacks suffer amputations and other injuries that can result in rapid loss of blood. Under the new program, medics have administered transfusions on nearly 90 flights and the program has saved lives, Klesney said.
“If we can get it even 15 minutes quicker or 30 minutes, sometimes that does make the difference between life and death,” she said.
The program started in southern Afghanistan because of the region’s continued high-level of fighting and the prevalence of roadside bombs, whose victims are the primary recipients of blood transfusions, said Navy Lt. David McDonald, trauma nurse coordinator for the Joint Theater Trauma System.
Flight medics must complete an intensive two-to-three-day training course to get certified to administer in-flight transfusions. They must do hands-on testing, in full body armor, to make sure they can perform the procedure in the chaotic conditions of flight.
“The back of an aircraft is very difficult to work in,” Klesney said.
Right now, only units in regional commands south and southwest, which include longtime trouble spots such as Kandahar and Helmand provinces, are able to administer in-flight transfusions. But eventually the program is expected to be implemented throughout Afghanistan.
It took until last year to get off the ground in part because most Army medics do not learn how to administer blood transfusions and the military had to design an intensive training program, McDonald said.
“It was a known deficiency of the Army Dustoff units; it was a known gap,” he said. “We have a 97 percent-plus survivability rate in theater and we’re just trying to eat away at that 3 percent.”
McDonald is collecting statistics on the program and said that so far, nearly 62 percent of in-flight transfusion recipients tracked have survived, a high rate considering the patients receiving transfusions are generally the most severely wounded they see.
Army Staff Sgt. Stephen Tschiderer, a flight medic based in Helmand province who has completed the transfusion training, said medics are used to administering intravenous fluids, helping them adapt to the new procedure.
“Anything we can do to increase the survivability of patients is huge,” he said.