Page 32 - JSOM Spring 2024

It was necessary to develop a tracking system for the canine as a secondary option. Stations with three or more working
blood. Owing to the small quantity of units collected in this canines are set up and prepared to perform as walking blood
initial endeavor, locally tracked identification numbers are bank collection and administration points in an emergency
provided for each unit. These unit numbers, along with other and thus not provided routine deliveries of CWB.
information, including collection date, transfer date, date of
arrival at destination, unit location, donor name, donor tattoo Future advances in canine transfusion medicine include hemo-
(4-character code specific to each MWD printed on the inside globin-based oxygen carriers and canine freeze-dried plasma,
of the ear pinna), donor blood type, donor hematocrit, donor but more research is warranted to elucidate their efficacy and
11
total protein, total bag weight, and expiration date, are placed safety. These technologies may eventually augment or even
into a web-based tracker available on a shared drive accessi- substitute CWB collection and distribution, especially in aus-
ble via a secure network at all outstations. This tracker also tere environments. In the meantime, there is a critical capa-
includes a section for comments regarding the disposition of bility gap in medical readiness for dogs, which leaves them
units (transfused, discarded, etc.). Each bag is physically la- vulnerable to death from massive hemorrhage caused by trau-
beled with collection and expiration dates, unit number, total matic battlefield injuries. Through collaboration and determi-
weight, donor name and tattoo, and donor hematocrit as well nation, successful neutralization of this gap will decrease the
as a “Veterinary Use Only” sticker. Each unit is transported risk of mortality for MWDs across the HOA Area of Opera-
in a biohazard bag with an additional identifying veterinary tions. This gap is not unique to the HOA Area of Operations
sticker. The overall workflow from collection to tracking CWB and this procedure can be translated to future locations and
is depicted in Figure 2. operations to improve the care we provide our MWD.
FIGURE 2 Flow diagram of military working dog (MWD) blood
collection, transport, and storage. Author Contributions
All authors were involved in the concept and implementation
of the endeavor discussed in the paper. EE wrote the first draft
Collection of CWB from MWD and all authors read and approved the final manuscript. The
authors have no financial relationships relevant to this article
to disclose. The authors have no conflicts of interest to dis-
close. This work was not supported by any funding.
Pick up of CWB by CCATT
Disclosures
The authors have no financial conflicts of interest to disclose.
Coordination of transport to
final destination References
1. Lagutchik M, Baker J, Brown J, et al. “Clinical Practice Guide-
lines for Military Working Dogs.” Joint Trauma System. https://
jts.health.mil/assets/docs/cpgs/Military_Working_Dog_CPG_12_
Dec_2018_ID16.pdf. Published November 19, 2018. Accessed
Package of CWB in Collins box November 21, 2023.
and transport to flight line 2. Lagutchik M, Baker J, Balser J, et al. Trauma management of Mil-
itary Working Dogs. Mil Med. 2018;183(suppl_2):180–189. doi:
10.1093/milmed/usy119.
3. Cannon JW, Khan MA, Raja AS, et al. Damage control resusci-
Arrival and unpacking at tation in patients with severe traumatic hemorrhage: a practice
final destination management guideline from the Eastern Association for the Sur-
gery of Trauma. J Trauma. 2017;82(3):605–17. doi: 10.1097/TA.
000000000000133.
4. Godbey EA. Whole blood transfusion: past, present, and future. Clin
Lab Med. 2021;41(4):659–667. doi: 10.1016/j.cll.2021.07.008.
Communication of arrival and 5. McCoy CC, Brenner M, Duchesne J, et al. Back to the future: whole
update of tracking system blood resuscitation of the severely injured trauma patient. Shock.
2021;56(1S):9–15. doi: 10.1097/SHK.0000000000001685.
6. Edwards TH, Wienandt NA, Baxter RL, Mays EL, Gay SD, Cap
CWB = canine whole blood; CCATT = Critical Care Air Transport AP. In vitro compatibility of canine and human blood: a pilot study.
Team. J Spec Oper Med. 2019;19(2):95–99. doi: 10.55460/6EAP-6E9G.
7. Giles JT III. Role of human healthcare providers and medical
Conclusion treatment facilities in military working dog care and accessibility
difficulties with military working dog blood products. US Army
Creating a program with minimal impact on the CLDJ and Med Dep J. 2016;157–60.
Combined Joint Task Force – Horn of Africa (CJTF-HOA) 8. Yagi K, Holowaychuk M, ed. Manual of Veterinary Transfusion
security missions require collaboration and effective com- Medicine and Blood Banking. Wiley-Blackwell; 2016.
munication among VS personnel, MWD kennel masters, and 9. Wardrop KJ, Birkenheuer A, Blais MC, et al. Update on canine
handlers. To minimize mission impact, we preferentially use and feline blood donor screening for blood-borne pathogens. J
Vet Intern Med. 2016;30(1):15–35. doi: 10.1111/jvim.13823.
transient canines as often as possible with the caveat that they 10. Edwards T, Palmer L, Venn E, Parker J, Majoy S. “Clinical Prac-
pass the screening process and are present at the CLDJ for at tice Guidelines: transfusion for the Military Working Dog.” Joint
least 72 hours. This also reserves resident canines for walking Trauma System. https://jts.health.mil/assets/docs/cpgs/Transfusion
_in_Military_Working_Dog_10_Dec_2019_ID77.pdf Published
blood bank donations if an emergency requiring CWB presents December 10, 2019. Accessed November 21, 2023.
at Camp Lemonnier. We routinely provide one unit of CWB at 11. Edwards TH, Meledeo MA, Peltier GC, et al. Hemoglobin-based
a time to each forward-deployed location with only one to oxygen carrier for the reconstitution of canine freeze-dried plasma
two working canines with operational missions. CPDA-1 an- in an in vitro model of resuscitation. J Spec Oper Med. 2022;22
(1):111–114. doi: 10.55460/YEYM-XU23.
ticoagulant bags are prioritized so donations are collected less
frequently; however, CPD anticoagulant bags are maintained PMID: 38360026; DOI: 10.55460/BLVF-5C1M

30 | JSOM Volume 23, Edition 1 / Spring 2024