Whole blood transfusion for exsanguinating coagulopathy in a US field surgical hospital in postwar Kosovo

Current use of donated whole blood consists of separating whole blood into components for defined transfusion needs. Transfusion of whole blood in modem trauma centers is uncommon. We report a case of exsanguinating nonsurgical bleeding in a patient treated at a US Army field surgical hospital in post-war Kosovo. After the transfusion of multiple units of packed red blood cells (PRBCs) and fresh frozen plasma (FFP), the patient became progressively coagulopathic. Because of the unavailability of platelet components for transfusion, an urgent active-duty soldier blood drive was performed at the field surgical hospital to obtain type-specific whole blood. Hospital personnel served as blood donors. The administration of whole blood reversed the coagulopathy, preventing fatal exsanguination. Consideration of whole blood transfusion should be made in circumstances in which component transfusions are not feasible. Activation of the "walking donor pool" may be the only means to obtain whole blood for transfusion in austere conditions such as a field surgical hospital.