Citation

Miller BT, Lin AH, Clark SC, Cap AP, Dubose JJ. J. Trauma Acute Care Surg. 2018; 85(1S Suppl 2): S134-S139.

Affiliation

Lieutenant Commander, Medical Corps, U.S. Navy, General Surgeon, Fleet Surgical Team Six, Assistant Professor of Surgery, Uniformed Services University, 1084 Pocahontas Street, Norfolk, VA 23511. mill1490@gmail.com Commander, Medical Corps, U.S. Navy, Senior Medical Officer, USS Bataan, Cardiology, Naval Medical Center Portsmouth, Assistant Professor of Medicine, Uniformed Services University, Medical Department, Box 412, AE 09554. andrew.lin@lhd5.navy.mil Commander, Medical Corps, U.S. Navy, General Surgery, Naval Medical Center Portsmouth, Associate Professor of Surgery, Uniformed Services University, 620 John Paul Jones Circle, Portsmouth, VA 23708. susan.c.clark2.mil@mail.mil Colonel, Medical Corps, U.S. Army, Chief, Blood Research, U.S. Army Institute of Surgical Research, Associate Professor of Medicine, Uniformed Services University, 3650 Chambers Pass, JBSA-FT Sam Houston, TX 78234. andrew.p.cap.mil@mail.mil Colonel, Medical Corps, U.S. Air Force, Associate Professor of Surgery, Uniformed Services University of the Health Sciences, 4501 Alhambra Drive, Apt 232, Davis, CA 95618. jjd3c@yahoo.com.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001831

PMID

29443862

Abstract

BACKGROUND: The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War.

METHODS: Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP). The blood supply can be augmented with WFWB collected from a "walking blood bank" (WBB).

RESULTS: Following a helicopter crash, six patients were transported by MV-22 Osprey to the USS Bataan. Patient 1 had a pelvic fracture, was managed with a pelvic binder, and received 4 units of pRBC, 2 units of FFP, and 6 units of WFWB. Patient 2, with a comminuted tibia and fibula fracture, underwent lower extremity four-compartment fasciotomy, and received 4 units of WFWB. Patient 3 underwent several procedures, including left anterior thoracotomy, aortic cross-clamping, exploratory laparotomy, small bowel resection, and tracheostomy. He received 8 units of pRBC, 8 units of FFP, and 28 units of WFWB. Patients 4 and 5 had suspected spine injuries and were managed non-operatively. Patient 6, with open tibia and fibula fractures, underwent lower extremity four-compartment fasciotomy with tibia external fixation and received 1 unit of WFWB. All patients survived aeromedical evacuation to a Role 4 medical facility and subsequent transfer to local hospitals.

DISCUSSION: Maritime military mass casualty incidents are challenging, but the U.S. Navy's casualty-receiving ships are ready to perform RDCR at sea. Activation of the ship's WBB to transfuse WFWB is essential for hemostatic resuscitations afloat. LEVEL OF EVIDENCE: V STUDY TYPE: Case series.

Language: en