The Armed Services Blood Program
Addressing a critical, worldwide need
23 April 2018
A combat-wounded soldier in World War II had approximately a 70 percent chance of survival. Those odds increased the sooner he reached an Allied hospital and received life-saving blood, according to a 2005 article in Science Daily by surgeon and writer Atul Gawande. As a result, during the war, military leaders and medical professionals quickly realized that the ability to provide blood for wounded service members as quickly as possible was an absolute necessity.
With more than 400,000 casualties, the second-deadliest war in American history saw the Red Cross initiate a national blood program that collected 13.3 million pints of blood for military use. In 1942, the Walter Reed General Hospital recognized this need for blood products and established the first military blood bank. Having its own supply on site was invaluable for the Walter Reed staff, because it helped them supplement blood donations from civilian collection agencies and provide more timely urgent care.
By the end of 1944, several other hospitals developed a means to collect and store whole blood as a result.
At the height of the Korean War, however, the military realized it didn't receive enough of a supply from civilian collection agencies. In 1952, the Department of Defense formally established the Armed Forces Blood Donor Program.
"It was very, very instrumental during the Korean War for distributing blood and blood products for our Korean War veterans," said Navy Capt. Roland Fahie.
The Armed Forces Blood Donor Program evolved into what is now known as the Armed Services Blood Program (ASBP), a joint operation that brings together Army, Navy, Air Force and combatant command blood programs. With 22 blood donor centers and 81 transfusion centers across the globe, the ASBP supplies military medical treatment facilities with blood products for regular operations, while collecting for contingencies as well.
The ASBP is able to separate whole blood donations into red blood cells, platelets and plasma. This process allows laboratories to provide only the specific parts a patient may need, and saves the rest for use elsewhere. Whether it be red blood cells for a loss of blood or certain types of anemia, platelets to aid in cancer treatment or plasma to help with clotting, the ASBP ensures each donation treats as many patients as possible.
"The red blood cells are for oxygen-carrying capacity, to bring oxygen to the tissue and keep that tissue alive," said Fahie. "The plasma is a little bit different, in the fact that plasma makes up about 55 percent of your blood volume. Plasma carries not only your platelets, or the liquid portion of your blood, but it also carries those clotting factors that are necessary for blood coagulation. Most of the time, our plasma is collected from whole blood collections. Normally, we will collect a donor from whole blood, and then we'll separate that into red cells and also plasma."
On a regional level, several facilities work to maximize each donation the ASBP receives. The Armed Services Blood Bank Center (ASBBC) at Walter Reed National Military Medical Center is one of those. The ASBBC is responsible for the collection, processing, storage and shipping of blood products for military, dependents and veterans across the National Capital Region.
On a daily basis, service members such as Hospital Corpsman 2nd Class Cortney Shafer ensure the center's blood products are free of viruses and bacteria, and that they reach the right patients at the right time.
"We have five facilities that we ship out to," said Shafer, a laboratory technician, "and they range from the VA, other government facilities such as Fort Belvoir, [Virginia, and] we also do what's called presidential support. Any time the president travels, he takes blood with him and we provide that blood for him. We also provide blood for Walter Reed here at transfusion services."
Walter Reed's ASBBC is one of five centers worldwide that coordinates efforts with individual service blood program offices, combatant commands and a joint blood program office.
"We are the sole provider for blood and blood products for the Department of Defense," said Fahie. "[We provide for] active duty, for our warfighters, for our military-eligible beneficiaries, and even our allies that we serve and the combatant commands."
According the ASBP website, the program has collected more than 5 million units of blood since its inception, and maintains a constant supply of 5,000 units of liquid cells and 65,000 units of frozen blood.