title: Bleeding management in remote environment: the use of fresh whole blood transfusion and lyophilised plasma.
abstract: To mitigate medical risks in remote environments, the authors have implemented an innovative integrated medical support solution for bleeding management on board ships since 2013. Fresh whole blood transfusion (FWBT) and lyophilised plasma were put in place to address life threatening haemorrhages in maritime operations in the Arctic and Antarctica. The authors are illustrating the bleeding risks with an actual case occurring in Antarctica prior to the implementation of these procedures. They are presenting the different steps involved in the complex process of FWBT, from blood donors' qualifications to actual transfusions. The pros and cons of blood transfusion in extreme remote environment are discussed, including the training of health care professionals, equipment requirements, legal and ethical issues, decision making in complex blood group matching, medical benefits and risks.
authors.affiliation: PMSm, France. sicarddoc@yahoo.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Sicard
authors.forename: Frédéric
authors.initials: F
authors.lastname: Marouzé
authors.forename: Céline
authors.initials: C
authors.lastname: Roche
authors.forename: Mathieu
authors.initials: M
authors.lastname: Carron
authors.forename: Sylvain
authors.initials: S
authors.lastname: Ausset
authors.forename: Anne
authors.initials: A
authors.lastname: Sailliol
mesh_terms: D000328:Adult; D000864:Antarctic Regions; D001110:Arctic Regions; D001782:Blood Donors; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D001803:Blood Transfusion / Q000295:instrumentation / Q000331:legislation & jurisprudence / Q000379:methods*; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D009326:Naval Medicine / Q000193:education / Q000941:ethics / Q000379:methods; D010949:Plasma
keywords: bleeding management; plasma; remote medicine; transfusion