Abstract

UK experience from recent conflicts in Iraq and Afghanistan has resulted in improvements in clinical care of injured patients. Resuscitation and blood transfusion is an area that has seen some of the greatest changes. The ongoing war in Ukraine has highlighted the challenges of medical support to Large-Scale Combat Operations (LSCO), one of which is the ability to deliver blood-based resuscitation near to the point of wounding.

Plasma is a key aspect of damage control resuscitation and balanced blood transfusion strategies. It is supported by a strong evidence base, which also demonstrates that early administration improves patient outcomes. Conventional plasma transfusion using thawed fresh frozen plasma (FFP) has logistical constraints that preclude its expedient use in the prehospital environment.

Temperature-controlled storage, and transport, of sufficient FFP to support LSCO is unrealistic, and temporary campaigns to increase civilian plasma donations signal a combat intent and could compromise Operational Security.

Dried plasma components are stable in storage at ambient temperature. They are easily and quickly reconstituted to produce a plasma component with clinically acceptable clotting and coagulation profiles. The UK has access to dried plasma from two European allies, but availability is very limited and use is off-licence. The ongoing UK dried plasma project will provide clinical, tactical and strategic benefits to UK and allied armed forces in future conflicts.