Rethinking the Operational Blood Bank Dilemma: Out of the "Box" Blood Storage and Transportation Evaluation.

Background: Blood transfusion is critical in modern trauma care. However, unreliable access to robust blood banking in austere military and disaster medicine settings remains challenging. Stored whole blood and components have strict refrigeration guidelines; any cold-chain storage liability that results in blood products deviating from their target temperatures affects patient safety. Refrigeration in a typical blood bank requires large, specialized devices. Transportable, battery-operated devices are available, but they have limited battery life. This study evaluated the possibility of using passively cooled devices (commercially available food coolers) to store blood components.

Methods: A commercially available 45-liter capacity cooler was used. Saline bags (500mL) were precooled to 1-6°C and placed in the cooler. A thermometer placed in the cooler adjacent to each saline bag measured the cooler temperature throughout each trial. The primary outcome was the hours of adequate refrigeration (between 1 and 6°C).

Results: There were four trials, each lasting 168 hours. Trials 1-3 maintained the goal temperature range for >142 hours, while trial 4 maintained temperature range for 78 hours.

Conclusion: Passive refrigeration using commercially available coolers and ice is a viable alternative to traditional blood storage solutions in austere, disaster, and military operational environments. Further studies should investigate prolonged blood storage using this technique with the periodic addition of ice.