Accuracy of 6.5″ Beaded Cable Tie, 10″ Paracord, and Operator Gestalt in Prehospital Whole Blood Collection Techniques in Filling Donor Blood Bags to Target Volume

Description

Accuracy of 6.5″ Beaded Cable Tie, 10″ Paracord, and
Operator Gestalt in Prehospital Whole Blood Collection Techniques in Filling Donor Blood Bags to Target Volume
Carlton DM, Jordan CS, Christensen M, Matthews KJ, Dassero B, Zarow GJ, Walther S, Emerling AD, Wier R, Auten JD Ahead of Print.
Publication Type: Journal Article (Feature Articles)

Abstract:

Background: Whole blood reduces mortality more effectively than blood component therapy in treating trauma. When cold-stored low-titer Type O whole blood (CS-LTOWB) is not available in austere environments, a walking blood bank (WBB) strategy is employed, with blood drawn from a local, pre-screened donor. Proper blood bag volume is essential for avoiding citrate-related complications; however, the optimal method for determining the correct blood bag volume is unclear.

Methods: Novices (n=65) and experts (n=10) at the 1st Marine Division each filled blood bags with the goal of hitting the target volume (450mL ±10%) using the 6.5″ beaded cable tie (BC), 10″ paracord (PC), and operator gestalt (OG) techniques. Filled bags were weighed on a digital scale. Correct fills, underfills, and overfills were assessed using nonparametric statistics at P=.05. Subjective assessments were also collected.

Results: For novices, OG achieved the highest rate of correct fills (69%), significantly outperforming BC (37%, P=.001) and PC (52%, P=.05). In experts, PC had the highest rate of correct fills (80%), though not significantly different from OG (70%, P=.59) or BC (50%, P=.08). OG was rated highest and was preferred by both groups. BC performed worst in objective and subjective measures for both groups.

Conclusion: BC performed poorly on all assessments and should be avoided. OG was generally superior to BC and PC, but was still suboptimal, with ~30% incorrect fills study-wide. Present findings demonstrate the need for better methods for determining donor blood bag fill volume to preserve the life of the wounded warfighter in WBB scenarios.

Keywords: prehospital blood; low-titer whole blood;
blood transfusion; combat medicine; hemorrhage; damage control resuscitation; walking blood bank; blood bag filling techniques; citrate toxicity; military trauma

PMID: 40952911

DOI: 10.55460/BO33-5BSJ