Accuracy of 6.5" Beaded Cable Tie, 10" Paracord, and Operator Gestalt in Prehospital Whole Blood Collection Techniques in Filling Donor Blood Bags to Target Volume

Whole blood reduces mortality more effectively than blood component therapy in treating trauma. When cold-stored low-titer Type O whole blood (CS-LTOWB) is not available in austere environments, a walking blood bank (WBB) strategy is employed, with blood drawn from a local, pre-screened donor. Proper blood bag volume is essential for avoiding citrate-related complications; however, the optimal method for determining the correct blood bag volume is un-clear. Novices (n=65) and experts (n=10) at the 1st Marine Division each filled blood bags with the goal of hit-ting the target volume (450mL ±10%) using the 6.5" beaded cable tie (BC), 10" paracord (PC), and operator gestalt (OG) techniques. Filled bags were weighed on a digital scale. Cor-rect fills, underfills, and overfills were assessed using nonpara-metric statistics at P=.05. Subjective assessments were also collected. For novices, OG achieved the highest rate of correct fills (69%), significantly outperforming BC (37%, P=.001) and PC (52%, P=.05). In experts, PC had the highest rate of correct fills (80%), though not significantly different from OG (70%, P=.59) or BC (50%, P=.08). OG was rated highest and was preferred by both groups. BC performed worst in objective and subjective measures for both groups. BC performed poorly on all assessments and should be avoided. OG was generally superior to BC and PC, but was still suboptimal, with ~30% incorrect fills study-wide. Present findings demonstrate the need for better methods for determining donor blood bag fill volume to preserve the life of the wounded warfighter in WBB scenarios.