Transfusion is a lifesaving capability and early transfusion is a proven lifesaving battlefield intervention.  However, an incompatible blood product transfused, especially with whole blood, could be lethal.  Training, education and leadership are necessary ensure safe transfusion practices in the deployed environments. 

Doctrine

Joint Publication 4-02, Joint Health Services; TM 8-227-12, Joint Blood Program Handbook; TM 8-227-11, Operational Procedures for the Armed Services Blood Program. ASBP DODI 6480.04

Organization

Units must be organized to support safe transfusion practices.  Safety officers and an organized culture of safety and awareness of the risks and benefits of transfusion should be fully understood by the unit.

Training

Service units should have appropriate transfusion training for both LTOWB and TSWB.

Units have the appropriate training for necessary laboratory testing for blood type confirmation prior to NBB-TSWB transfusion.

Materiel

Manual saline tube test or automated analyzer

Leadership

Medical and ASBP leadership must ensure that units are prepared, trained, and understand the indications for the use of Type A Specific Whole Blood (NBB-TSWB).  Incompatible blood transfusions can be lethal, therefore, leaders must understand this and educate the deployed medical units on primary transfusion products, as well as contingency and emergency options.

Personnel

Qualified personnel in the blood banks and assigned to support transfusion when the role of care does not have a blood bank.

Facilities

Role 3 - these echelons must have the laboratory equipment necessary for confirming blood type prior to transfusing NBB-TSWB.  These facilities will also require refrigerators with appropriate temperature monitoring required to store NBB-TSWB. 

Policy

ASBP DODI 6480.04, Section 1.2; local Role 3 standard operating procedures