JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —
The U.S. Army Institute of Surgical Research at Joint Base San Antonio-Fort Sam Houston hosted a biannual meeting of the Federal Inter-Agency Task Force for Trauma and Emergency Preparedness Nov. 8-9, 2018, which focused specifically on delivery of blood products at the point of injury, where their use is most life-saving.
Trauma is not just a military issue. According to the Centers for Disease Control, or CDC, it is the leading cause of death for civilians up to the age of 45 years (47 percent), and the fourth leading cause of death overall for all ages.
By comparison, cancer accounts for 12 percent of mortality up to the age of 45. It is increasingly clear that significant logistical constraints and other challenges limit the ability of medical professionals to deliver optimal treatment, especially blood products, to trauma patients – whether in mass casualty scenarios, natural disasters, or on the battlefield.
Blood transfusions are essential to treat the number one cause of preventable death due to trauma – namely, fatal blood loss. There are too few blood donors, and technologies for blood storage and delivery are currently inadequate, making blood unavailable where and when it is most needed, immediately after injury. Overcoming these challenges demands a whole-of-government effort.
The November meeting included representatives from USAISR, the Biomedical Advanced Research and Development Authority of the U.S. Department of Health and Human Services, Special Operations Command, the 59th Medical Wing, Navy Advanced Development, the Armed Services Blood Program, the National Heart, Lung and Blood Institute of the National Institutes of Health, the U.S. Food and Drug Administration and the National Aeronautical and Space Administration. These organizations are uniquely positioned to partner in addressing these complex issues.
The interagency effort tackles challenges associated with expanding the window for life-saving care by increasing the supply of readily accessible, quality blood products with broad clinical application – for treating explosive injuries, blunt and penetrating trauma, chemical, biological, and nuclear weapons effects as well as delivering care for extended periods of time in remote or contaminated environments.
The group developed the "Interagency Strategic Plan for the Research and Development of Blood Products and Related Technologies for Trauma Care and Emergency Preparedness 2015-2020” in direct response to a recommendation issued by the National Security Staff during a 2013 Catastrophic Events, Blood Availability meeting.
The plan leverages resources and expertise, and continues to build cohesive programs across the government that enable cooperative interagency programs that no single agency could conduct alone.
Dr. Tammy Crowder, USAISR deputy director of research, said the meeting was one of several that have been held since 2015.
“The overarching goal is to improve patient outcomes following combat trauma and mass casualty events by developing and executing a plan designed to close critical gaps in patient care, and this meeting focused specifically the delivery of blood products and blood-related resources and technologies,” Crowder said. “The early delivery of blood products reduces trauma mortality by as much as 50 percent.”
Crowder described DOD-funded research efforts including studies conducted at 15 Level 1 trauma centers, who are part of a clinical research network known as LITES, or Linking Investigations in Trauma and Emerging Services.
The LITES research network has capability to conduct prospective, multicenter, injury care and outcomes research supporting the goals of the interagency strategic plan, such as early transfusion of blood products following trauma.
USAISR plays a central role in the plan by conducting research on how to extend the shelf life of platelets, which contribute to hemorrhage control, Crowder added. Through their research, USAISR researchers have found a better way to store platelets, extending their shelf life from five to 14 days.
During the November meeting, Crowder said there was promising reports from scientists and researchers from four companies on the development of blood products and related technologies, which she said was “extremely exciting.”
By working together, Crowder said the agencies involved will more quickly advance towards achieving the goals of the interagency plan.
USAISR will host the next interagency meeting in spring 2019.
(David DeKunder from the 502nd Air Base Wing Public Affairs office contributed to this article)