News: RC-East medevac crews train to provide life-saving en route blood transfusions
Story by Staff Sgt. Todd Pouliot
BAGRAM AIR FIELD, Afghanistan – The crucial step in saving the life of a casualty with a traumatic injury is to stop blood loss, but medical personnel know that if higher level follow-on care is not provided in a timely manner, the casualty could still succumb to shock.
“If someone loses 30 percent or more blood volume, he or she will be in Class III shock,” said Maj. Geoffrey Chin, MD, a flight surgeon assigned to 3rd Battalion (General Support), Task Force Phoenix, 10th Combat Aviation Brigade. “Interventions must be done within seconds to minutes in order to save a life at that point.”
Chin is leading the training of 10th CAB flight medics from throughout Regional Command – East, Afghanistan, along with en route critical care nurses who accompany the medics on missions, on a procedure which will improve the survivability of casualties with traumatic injuries.
The procedure is called Vampire Protocol and gives flight medics the capability to infuse blood in the aircraft while en route to higher level care facilities. Eighteen medical evacuation personnel completed the training Sept. 25-26, at Bagram Air Field.
“The Vampire Protocol, which has been conducted in RC-South for about a year, is a medical guideline for giving emergent blood transfusions,” said Maj. Lance Kunz, D.O., 10th CAB flight surgeon, who coordinated the training. “It is designed for a patient who has suffered significant blood loss from combat trauma like amputation of limbs or internal bleeding.”
Up to now, medevac crews picked up casualties who had received preliminary care on the ground, and treated symptoms of their wounds en route with intravenous fluids. Now, instead of merely making short-term interventions, flight medics can respond directly to the underlying cause of those symptoms with blood product infusions.
“What the ground medic and combat lifesaver do, such as placing tourniquets and treating life-threatening lung injuries, goes a long way to keeping our soldiers alive,” Chin said. “If, however, those life-saving interventions are not effective and the soldier is still in shock, blood transfusions can prevent irreversible damage to the body from oxygen deprivation to vital organs and help prevent further blood loss.”
Medevac crews will now carry packed red blood cells, which help increase the oxygen-carrying capacity of the recipient’s blood, and thawed plasma, which contains clotting factors, added Chin.
“Blood is so much more beneficial than fluids because blood carries oxygen and has clotting factors which are able to stop the bleeding,” said Sgt. Samuel Garced, a flight medic assigned to C Company DUSTOFF, 3rd Battalion (General Support), 10th Combat Aviation Brigade. “To actually get this training is satisfying because our capabilities will multiply dramatically. Finally we’re catching up with being able to do something about it versus just knowing what would be great for the patient.”
Day one lessons covered blood immune-histology, blood bank handling/storage procedures, medical complications related to blood transfusion, management of complications, and an equipment overview and demonstration. The flight medical personnel took a written exam the following day and then the flight medics and ECCNs paired up to perform two practical exercises in the back of the medevac helicopters during day and night iterations.
“Blood loss is the leading cause of death on the battlefield,” Kunz said. “The earlier we are able to stop bleeding and replace the loss the better it is for the patient. I think Vampire will increase the chance of survival of soldiers who have suffered significant blood loss.”
Chin said he will be traveling to other sites in the coming weeks to ensure that every flight medic in RC-East is trained to proficiency on this protocol. The training will also be passed on to newly arrived medevac units.