BLOOD SUPPLY MANAGEMENT IN AUSTERE CONDITIONS

Abstract

India has had very tragic experience, on numerous occasions in past with disasters of all kinds. Disasters may be manmade (battlefield, mass causalities by explosion etc) or natural (earthquake, tsunami, floods etc) inflicting massive impact of all kinds on the mankind.  Apart from the effect on infrastructure, major irreparable impact is on the lives of those engulfed in the disasters leading to loss of lives and sustaining disabilities due to injury and blood loss. Hemorrhage accounts for the primary cause of death in any austere conditions, and is associated with almost two thirds of the potentially salvageable deaths. All these conditions have a common bottleneck, ie long transit time for definitive care of injury /trauma management in most cases and significant delay in evacuation of those affected. During managing these cases, blood and blood products are literally the life saving element. But unfortunately, there are huge logistical limitations in providing large volumes of transfusion fluids at the place required. Thus, there is a need for specific transfusion policy, enshrining the concept of damage control resuscitation and damage control surgery, to ensure, those injured, receive the best possible transfusion fluid within limited timeframe, to ensure his survival. The use of specific blood & blood products and in specific ratios will improve survival rate and reduce or prevent early and late deleterious transfusion sequelae. In addition, we need to be ready to embrace the latest innovations happening in the world and ensure that the same can be included in our disaster management system, so as to develop a feasible and optimal transfusion policy for stabilization of casualties in any austere condition thus having a positive impact on the whole life and limb saving efforts.