Potential delays in medical treatment are a constant concern when the blood supply is low for frontline medical professionals attending to injured military personnel. Factors such as inappropriate storage facilities, inability to combat extremes of temperature or monitor the quality and condition of blood and blood products result in unreliable supplies for injured personnel on the frontline. These constraints are faced by the world?s leading military medical corps, including those in India.
Help is round the corner in the form of a new technology being offered by UK-based General Dynamics to the Indian armed forces. The company?s bulk medical storage facility (BMSF) is a high-tech temperature-controlled medical storage facility, which might help Indian military medics save lives on the frontline, or even those battling terrorism in various parts of the country.
Bulk medical storage facility can hold the equivalent volume of blood products to a small hospital blood bank. It is designed to work in extremes of temperature and at present, the UK military is the only force in the world to have this capability. The facility provides secure storage for medical material at deep frozen, refrigerated and ambient temperatures simultaneously, even when external temperatures rise as high as 58 degrees centigrade or drop as low as minus 26 degrees centigrade.
According to Mark JS Douglas, vice-president, General Dynamics, the ability of many of the world?s military medical corps to ensure a safe, secure and speedy supply of blood and blood products to frontline medics is severely constrained these days. One of the key issues faced by medical corps at forward field hospitals is how to ensure the safe and secure availability of blood, blood products and medicines at a short notice. Currently, there is no equipment in service for the storage of blood products or medicines in forward positions that will monitor and store a range of temperature-controlled products. When blood transfusions or drugs are needed, medics send an urgent request for these products to base camp.
Depending on availability, blood could take up to 24 hours to reach the patient in question, while even some drugs could take a few hours. This potential delay can severely eat into the so-called ?Golden Hour? during which chances of survival can diminish without prompt treatment.
?General Dynamics? bulk medical storage facility has been selected by the British ministry of defence to help save more lives on the frontline. We are offering this facility to the Indian forces as there is a huge opportunity for this here,? says Douglas. The key benefits of bulk medical storage facility include speed of delivery, drug control, mobility, temprature control and protection from expiration.
According to doctors of the Indian army, using items of current ?cold chain? kits such as ?Golden Hour? boxes or ?Thermopol? containers is not recommended for keeping products fresh for extended periods as such kits are only effective within certain temperature and time ranges. Hence it puts susceptible ambient products at risk in extreme heat or cold or long durations. Often the net effect of using this kit for storage is wastage, putting more pressure on the supply chain. As such, the bulk medical storage facility transplants the capability of a small hospital blood bank in one contained unit to the frontline. Based on a standard 20 feet container, the facility provides a major advance in capability for frontline medics?a portable, secure, temperature controlled unit that makes blood and medicines that need temperature protection immediately available.
The bulk medical storage facility can be easily airlifted via all standard military means, fitting perfectly inside existing military transport planes such as C17 Globemaster, Hercules C130K and Super Hercules C130J or future Airbus A400 transport aeroplanes. It can also be easily dropped into the front line as it is certified for lifting with slings beneath a Chinook heavy-lift helicopter, and can be transported by all normal commercial freight systems including commercial shipping, rail and road transportation.
When the bulk medical storage facility arrives at its destination, it can be easily ?hooked up? to expeditionary infrastructure power supplies, or if none is available, work off its own on-board power generator. Keeping blood products at a constant 4 degrees centigrade for eight hours without power, the facility will ensure the right blood gets to the right injured person at the right time and in the right condition. ?This will significantly enhance our transfusion capability in the field,? says Douglas.
Supply of reliable blood supply is not felt by medical professionals in the battlefield alone. In a natural disaster scenario such as the earthquakes in Indonesia and the Samoan tsunamis, the ability to quickly drop a unit containing vital medical supplies and equipment into that zone would likely have helped aid agencies save more lives. Having a supply of bloods and medicines that could be kept to the correct temperature until they are needed would make the job of doctors in these difficult conditions much easier.
According to officials at General Dynamics, fresh blood is better than stale. It carries more oxygen and, when transfused into patients, speeds recovery. Military medics are all too familiar with this problem in the field, where donated blood may take two or more weeks to reach soldiers who need it immediately. But medical researchers ?also known as blood pharmers?are working on manufacturing the red stuff on the spot.
The US defence department?s research arm, Defense Advanced Research Projects Agency (DARPA) has teamed up with a Cleveland-based biotech company called Arteriocyte. The latter has developed a nanofibre based system, or NANEX, a technology that enables the production of red blood cells without a donor. The two collaborators hope that their research will eventually lead to an ?in theatre? blood-making machine for the military.
Meanwhile, an ultra-modern fully air-conditioned, rapid action mobile medical hospital was recently inducted into the Indian Air Force (IAF) at the Hindon airbase near Ghaziabad. IAF officials inform that the mobile medical hospital is field/disaster area deployable 25-bedded hospital with a full complement of operation theatre, oxygen generating system and other sub-systems that would aid the military and civilians in both disaster areas and operational grounds. The system is air/road transportable and will serve as a key force multiplier to the expert disaster medical management teams on ground who have till now been working under serious constraints of facility.
Without any doubt, the acquisition sophisticated healthcare equipment such as blood storage containers and mobile hospitals will help military medics save lives of soldiers guarding the frontiers.