Operational Blood Management
Wartime, conflict, and joint operational blood management, however,
are the responsibility of the unified CINC who is conducting operations.
Generally, the Unified Command Surgeon establishes a JBPO to control the
process. If needed to support multiple operations or regions, the surgeon
also creates one or more AJBPOs. As part of the planning process, the surgeon’s
staff decides where the JBPO/AJBPOs will locate. Additionally, the surgeon’s
staff determines how many Blood Transshipment Centers (BTC) and Blood Supply
Units (BSU) will be needed to ensure adequate stocks in theater. The command’s
Air Force component controls BTC operations, while BSUs may be provided
by any service. The Unified Command Surgeon may direct one service’s BSU(s)
to provide theater or area support on a joint basis. This is especially
likely when an established BSU is already within the JOA.
Blood requests generally originate at using activities. Although each service
may handle the requests differently, the general rules of thumb are as
follows:
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No blood is available at echelon I units or facilities.
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Only type O blood is available at echelon II units or facilities.
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Multiple blood types are available at echelon III, IV, and V facilities.
Medical units that use blood, submit requests for replenishment to their
supporting BSU. The BSU then issues the blood and, in turn, consolidates
resupply requirements and forwards them to the JBPO/AJBPO. The JBPO relays
these requirements to the ASBPO, and the ASBPO directs one of two of the
Armed Services Whole
Blood Processing Laboratories (ASWBPL) to ship the blood. Blood is
transported by the most immediate means available—usually strategic aircraft—into
theater. There, the blood is off-loaded at the theater BTC (TBTC), re-iced,
and loaded on theater aircraft or other transport vehicles for shipment
to the ordering BSU. |