Wartime Strategies to Save Lives at Home


DENVER, Colo. (Ivanhoe Newswire)— It can be the toughest of situations, working on the wounded in a war zone or combat field hospital. The injuries can be devastating. Now, wartime strategies are being incorporated back here at home. The result, more lives are being saved.

Jimmy Manzanares remembers the exact moment his life changed.

“A truck hauling some trailers pulled out in front of us,”  Manzanares recalled.

His leg trapped in the twisted metal of his delivery truck.

Manzanares shared, “I just remember asking, do I still have my leg? Do I still have my leg?”

Warren Dorlac, MD, trauma surgeon at UCHealth Medical Center of the Rockies explained to Ivanhoe, “By the time he arrived to us, he probably lost anywhere between 30, 40 percent of his blood volume.”

(Read Full Interview)

Trauma surgeon Warren Dorlac uses whole blood to treat trauma patients like Jimmy.

“Whole blood is basically the blood that we would pull out of your body right now,” clarified Dr. Dorlac.

A retired colonel, Dr. Dorlac says whole blood dates back to treating soldiers in WWI. Today, most trauma patients receive component therapy. That means donated blood is broken down.

“So, we would give you a certain number of red cells, we might add some plasma into that. And then we might throw in some platelets,” illustrated Dr. Dorlac.

But severe trauma patients need it all.

“If I have someone that has hemorrhagic shock and has had a large amount of blood loss, then really I want to give them back whole blood,” Dr. Dorlac shared.

Whole blood improves coagulation, reduces exposure to multiple donors which decreases the risk of infections and blood related diseases. As for Jimmy, with five surgeries down, a few more to go, he’s taking it step by step.

“I’m just fortunate to be alive. I’m just glad to be alive,” Manzanares revealed.

Most whole blood donors are type O, which is a universal donor and can be used on any patient, no matter their blood type. Whole blood units go through a 48-hour testing period and can be refrigerated up to 21 days. The shelf life for traditional donated blood is 42 days.

Contributors to this news report include: Cyndy McGrath, Executive Producer; Marsha Lewis, Field Producer; Rusty Reed, Videographer; Roque Correa, Editor.

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REPORT:       MB #4773

BACKGROUND: IN WWI AND WWII, whole-blood transfusions were the most common techniques used to treat military massive traumatic hemorrhagic shock. The other most prevalent practice now is blood component therapy that utilizes a targeted ratio of red blood cells, platelets, and plasma. More than 22 million blood components are transfused each year in the United States. Component therapy allows for donor blood to be extended for many possible uses. Whole blood, also called WB, includes all of these elements and is not broken down after donation. WB allows for patients with traumatic hemorrhages to get the maximum amount of life- saving elements from transfusion as possible.

(Source: https://pubmed.ncbi.nlm.nih.gov/30904380/)

COMPONENTS: Whole blood contains 45 percent red cells, white cells, and platelets suspended in 55 percent blood plasma and has a shelf life of 21 to 35 days. Whole blood is the simplest and most common type of donation and is utilized for patients with severe blood loss but can also be refrigerated for later use. Red blood cells, also called erythrocytes are what give blood it’s vibrant color. They are produced in bone marrow and are responsible for carrying oxygen from the lungs to the rest of the body as well as delivering carbon dioxide back to the lungs to be exhaled out of the body. They can last refrigerated for up to 42 days and are used for blood loss, blood disorders, and anemia. Platelets, also called thrombocytes are also made in our bone marrow and are tiny, colorless, fragments of cells that stick to the lining of vessels to aide in preventing or stopping bleeding. They will only last five days at room temperature with constant agitation to prevent clumping. They are mainly used for cancer treatments and organ transplants. Plasma is the yellowish liquid that platelets, red, and white cells are suspended in and runs throughout the body. Plasma can last frozen for up to a year and is mainly used for burn and shock patients.

(Source: https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-donations/blood-components.html)

NEW TECHNOLOGY: After several decades of non-use in civilian hospitals, whole blood is starting to be reintroduced as a way to treat trauma patients in the emergency room as well by anesthesiologists in massive transfusion situations. Its reported that 40-50,000 deaths in the U.S. each year could be prevented with appropriate hemorrhage control and resuscitation. These lost patients are usually young, otherwise healthy individuals that suffer traumas. Our knowledge of the effectiveness of whole blood comes primarily from the military ranging from the 1800s, to both world wars, to the Vietnam and Korean wars. Medicine was redirected towards mainly utilizing component therapy in the 1980s, but now in the 2020s whole blood is being revisited as a necessary staple. The single donor source of whole blood reduces risk of disease transmission and has reported low complications in study subjects.

(Sources: https://pubmed.ncbi.nlm.nih.gov/29771715/, https://www.stemlynsblog.org/whole-blood-in-trauma-st-emlyns/




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If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Doctor Q and A

Read the entire Doctor Q&A for Warren Dorlac, MD, Trauma surgeon

Read the entire Q&A