Page 64 - JSOM Spring 2024

group O blood Servicemembers screened, 39 (95%) were de- on the LSD with 12 prescreened LTOWB donors (only 7% of
termined to be LTOWB; 3 of these members were RhD(–) and all the potential group O blood donors [Figure 3]).
36 were RhD(+). Once underway on Northern Pacific mari-
time operations, the ERSS team performed several WBB drills FIGURE 3 Flowchart of whole blood donors aboard dock landing
in collaboration with the ship’s Independent Duty Corpsman. ship (LSD), from eligible donors to final number of personnel
embarked and available to participate in walking blood bank drills.
During the drill, 17 of the 39 LTOWB-eligible Servicemembers
arrived at the staging area within 5 minutes of announcing
the activation of the WBB (Figure 2). This response time was
reproducible during normal shipboard operations. However,
during the after-action review of the exercise, it was noted
that during a shipboard emergency (General Quarters) eligi-
ble blood donor response time would likely be significantly
longer. In such a scenario, medical operations would be sec-
ondary to the mission of shipboard damage control measures
and coordination with the Damage Control Center would be
required to form a limited WBB with donors not performing
mission-critical tasks.

Once underway, the ERSS team performed WBB drills, and all
the 12 potential LTOWB donors arrived at our staging area
within 5 minutes of activating the WBB. During the after-
action review, it was again noted that during a shipboard
emergency (General Quarters), this response time would likely
FIGURE 2 O blood
group walking blood be significantly longer. Given the low turnout, in comparison
bank drill. to prior experience on a DDG, the team performed a survey of
the crew that were eligible group O blood personnel but chose
not to undergo screening. This survey was performed to un-
derstand the current challenges of conducting LTOWB drives
on naval vessels that are not doctrinal maritime medical re-
ceiving ships. Of the 119 group O crew members who did not
undergo LTOWB screening, 42 completed the survey ( Table
1). Of note, there had been three prior outbreaks of SARS-
CoV-2 among the LSD crew prior to this operational mission.
It is unclear whether this factored into the overall low num-
ber of LTOWB donors as only 37% of those screened were
LTOWB Walking Blood Bank (Harper Ferry’s Class LSD) found to be LTOWB. It is unclear whether repeated infections
The INDOPACOM ERSS team was deployed onboard a Harp- with COVID-19 can increase anti-A and anti-B blood titers to
er’s Ferry Class Dock Landing Ship (LSD) from April to May above the 1:256 threshold that is currently used for reporting.
2022 on an operational mission in the Southern Pacific Ocean.
In the 2-week pre-mission period, the team coordinated with TABLE 1 Primary Reasons Sailors Did Not Participate in Low-Titer
the NMRTC San Diego Blood Bank to perform screening on all Group O Whole Blood Screening Drive
eligible group O blood donation volunteers. Of the total crew No. of
(364 members), 165 members were determined to be potential Reason Sailors
group O blood donors on initial screening of medical records. Too busy 9
Only 56 (34%) of the potential group O blood Servicemem- Fear of needles/blood 9
bers volunteered to undergo blood grouping, antibody testing, Thought G6PD or sickle cell trait were disqualifying 7
anti-A and anti-B titers, and infectious disease screening. Ten for blood donation
Servicemembers were excluded from the screening process af- Unaware of blood drive 6
ter initially volunteering. Of the 46 remaining volunteers, two Not on ship day of drive 5
were found to be ineligible for donation because their Defense Do not want to disclose 6
Enrollment Eligibility Report System (DEERS) documentation
was incomplete; two had inadequate blood samples collected LTOWB WBB (Nimitz Class CVN)
in the tubes; and one was reported to be group A. This left The INDOPACOM ERSS team was deployed onboard a Nim-
41 eligible screened members, 15 of whom were determined itz Class Aircraft Carrier (CVN) in June 2022 on an opera-
to be low anti-A, low anti-B titer donors (37% of the screened tional mission in the Western Pacific Ocean. WBB screening
group O donors). Three of these members were left behind on a of the CVN’s crew without the air wing had been conducted
“beach detachment” and did not get underway on the mission. during the predeployment period, prior to the ERSS team arriv-
This left 12 prescreened LTOWB crew members; 1 was RhD(–) ing. The CVN’s crew, without an air wing, was 2,500 person-
and the remaining 11 were RhD(+). The ERSS team embarked nel, 403 of whom had volunteered to participate in the WBB.

62 | JSOM Volume 23, Edition 1 / Spring 2024