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Story by Tech. Sgt. Robert Cloys
BAGRAM AIR FIELD, Afghanistan – Life-saving platelet transfusions are needed every day by injured service members and patients with life-threatening injuries.
At the Craig Joint Theater Hospital at Bagram Air Field, Afghanistan, a small team of Army and Air Force members perform the critical task of acquiring those platelets. Platelets aid damaged blood vessels by forming clots at the site of injury preventing further blood loss.
“We need platelets on almost a daily basis because we support both of the Role 3 facilities in theater,” said Capt. Jacquelyn Messenger, 153rd Blood Support Detachment commander. “We are currently the only place in Central Command that collects them.”
Both Bagram and Kandahar Air Fields in Afghanistan have NATO Role 3 hospitals capable of providing many of the same treatment capabilities as major hospitals in non-austere environments.
The shelf life of platelets is limited to only five days, making it impossible to import from continental United States. In order to have this critical blood component available in theater, the BSD uses an apheresis machine to collect platelets. Blood is drawn out, platelets are extracted and remaining blood components are returned to the donor.
“The platelet unit that we get from a donation is a concentrated version. That’s one of the reasons we draw them,” said Spc. Lauren O’Neal, 153rd BSD medical laboratory technician. “It takes six units of whole blood to get what you would get from one unit of platelets. When we are collecting platelets, we are actually giving all your red cells back through the same needle. We keep the platelets, but everything else we don’t need we give back. We end up processing almost half of the body’s blood volume to get that amount of platelets in about six cycles.”
The donation process takes approximately two hours to complete. Fortunately, the process is different than a normal blood donation, and members are able to immediately return to their jobs.
“Red blood cells provide oxygen carrying capacity and we give all that back,” said Messenger. “So it’s not going to affect your ability to perform and do your missions.”
Before any lifesaving can be accomplished in the operating room, careful sorting has to take place in the lab.
“After we get all of the blood components, it’s our job to make sure its compatible with those receiving it,” said Tech. Sgt. Joye Lamme, 455 Expeditionary Medical Operations Squadron medical laboratory NCO in charge. “There is zero tolerance for errors in blood donations. We can’t give the person the wrong blood type or the wrong component when providers are requesting them, and we have to make sure that the OR gets the blood right away.”
Once the lab has completed their tests to ensure compatibility, the blood is available to be transfused.
“When someone has a life-threatening injury and is hemorrhaging, I need to replace their blood loss to give time for the surgeons to control the bleeding. Recently, we had a patient with massive blood loss that required over 50 units packed red blood cell, 50 units of plasma and 24 units of platelets. The patient would not have survived his injuries without having blood available,” said Lt. Col. Anita Upp, 455th EMDOS Operating Room flight commander.
Since July 2015, the 153rd BSD apheresis team at CJTH has collected 181 platelet donations and pre-screened nearly 400 potential donors; of those donations, 35 have been used in transfusions.
Although the blood routinely used at the hospital comes from U.S. military donor centers, the hospital does have the ability to draw whole blood during emergency situations when blood resources are scarce. This is accomplished by utilizing a large donor pool of pre-screened U.S. donors local to the emergency area.
“We maintain an active donor pool, which is why we do the pre-screen drive every 90 days,” said Messenger. “We collect information to make sure potential donors are eligible to donate, do testing for infectious diseases to make sure that they are safe to donate, and keep a roster of when they are going to redeploy, their contact information and their blood type so we know exactly who we can contact for each blood type needed.”
Because all platelet donations are universal, unlike whole blood, donated platelets are kept on hand to be utilized by any patient in need. With the aid of the Army apheresis team and the dedication of routine blood donors, the CJTH blood bank is a life force in the event of a trauma.