Page 20 - JSOM Winter 2021

2. Accept blood products into receiving unit’s TMDS inventory. 3. Units who implement this CPG will train appropriate per-
If receiving unit is unable to access TMDS, the issuing fa- sonnel on the following:
cility will access account and receive the products under a. Emergency procedures for in-flight complications.
the receiving unit’s TMDS inventory. b. Storage container/blood product exchange requirements.

Storage, Transportation and Essential Items Required for Implementing
Monitoring of Blood Products a Vampire Program
1. All blood and blood components must be maintained in 1. Approved blood component transport container.
a controlled environment and stored under appropriate a. Recommend between 4 and 6 each GHCs for a Vampire
conditions. Program (NSN 6530-01-505-5301 (OCP)/5306(Desert)).
2. Blood products carried outside a BSD/MTF/Lab will only be b. Hemacool (NSN 4110-01-506-0895) or other freezer
transported in an approved storage container (e.g., Golden with temp check to ensure a temperature ≤ to (–) 18°C
Hour Container NSN 6530-01-505-5301; OCP/5306; Des- to support reconditioning of GHC.
ert) for a maximum of 48 hours. 2. Safe-T-VUE (NSN 6515-08-T00-3056) for temperature
3. Units will monitor containers and document status (e.g., monitoring. (Refer to Appendix E.)
dry/no leaking noted) at a minimum of every 24 hours. 3. Establish Theater Medical Data Store (TMDS) accounts for
4. Once loaded and sealed, container will remain closed and an issuing facility (BSD/MTF (Role2/3) and LAB); and re-
intact at all times until blood product is required for patient ceiving unit (evacuation unit)
care.
5. Notify the issuing facility (BSD/MTF/Lab) as soon as possi- Warming Devices for Blood Transfusion
ble when blood products have been used. Use of infusion warming devices is highly recommended.
6. GHC is only approved for 48 hours use; prior to expira- These will be FDA approved for the actual use in transfusion
tion end users will contact issuing facility (BSD/MTF/LAB) of blood products (examples of devices include: Belmont
®
®
™
to coordinate the return and exchange of a container and Buddy-lite , EnFlow or Thermal Angel).
blood products per mission requirements.
WARNING: Warming devices will have safety mechanisms
WARNINGS: built in that prevents the output temperature from exceeding
– At no time will container or its contents (blood prod- 42°C. Unit personnel will be familiar with safety mechanisms
ucts) be placed in a refrigerator or other cooling device for the device used.
outside a blood bank.
– Blood products will not be used if container is leaking; Tranexamic Acid (TXA)
or the temperature indicator (Safe-T-VUE) on the blood Patients receiving blood transfusion within three hours of in-
product is out of standard (refer to Appendix E). jury should also receive TXA. Refer to the TCCC guidelines
– Notify the issuing facility and return container and for administration of TXA.
products for replacement.
Record Keeping and Documentation Requirements
Individual and Unit Training Requirements 1. Transfusions will be documented into TMDS by evacuation
1. At a minimum, medical personnel who participate in the personnel, or, by issuing facility.
administration of blood products during evacuation will be 2. Personnel will refer to the Theater Blood Application
trained in the following topics: Training Guide, 02 Jun 2014 for directions on Inventory
a. Indications for transfusion (Appendix C) Management-and for Transfused Products.
b. Transfusion procedures (Appendix D); 3. Complete SF 518 documentation and turn over at the des-
c. Documentation (Appendix G) tination MTF for placement in the patient’s medical record.
d. PEARLS for transfusion (Appendix F)
e. Submission of a patient safety report when required References
2. At a minimum, non-medical personnel who assist will be 1. Armed Services Blood Program (ASBP), Joint Blood Program
trained in the following: Handbook, HQ Departments of the Army, Navy and Air Force
a. Transfusion procedures (Army Technical Manual 8-227-12, NAVMED P-6530, AFH 44-
152-IP), 01 Dec 2011.
b. Equipment/supplies 2. Central Command Regulation (CCR) 40-1, Quality Management
c. Documentation requirements for the SF 518 (QM) Programs in Healthcare Operations, 19 Feb 2016.
3. CCR 40-4, Clinical Operations (CLINOPS) Program, Jan 2016.

18 | JSOM Volume 21, Edition 4 / Winter 2021