Western troops may face deadlier fights in future wars. If helicopters can’t fly medevac flights, the US Army’s fallback for treating the wounded is a World War I approach: using soldiers as “walking blood banks.”
During a recent exercise on a German hillside, the Army and its allies and partners simulated enemy artillery fire that resulted in tremendous soldier casualties. Without air superiority for flying evacuations for the injured or bringing in needed supplies, life-saving treatment had to be done right near the fight.
Front-line Army medical personnel practiced an old tactic making a comeback, with troops lining up to give blood directly to the wounded right on the battlefield. In this situation, blood transfusions were done with donations from soldiers who were pre-screened and prepared to donate blood on the fly.
The exercise saw US soldiers from the 2nd Cavalry Regiment and 1st Armored Division Combat Aviation Brigade training to provide prolonged care in the field, a necessity in situations like the Ukraine war, or potential future conflicts, where contested air makes it difficult to move injured troops off the battlefield for trauma care in the critical “golden hour” window.
The US and its allies were able to enjoy that during the conflicts in the Middle East, but that might not be an option in the future.
“What we’re looking to do is to try and exercise the delivery of giving blood, in a far forward situation, from our own organic sources,” said Maj. Cat Kemeny, the regimental medical officer with 4 Regiment Army Air Corps, British Army, per a US Army release. “Those organic sources are people.”
Kemeny said that troops are an ideal source because the blood is stored at a perfect temperature in their bodies and makes for a quick transfusion with no degradation due to time or travel.
Walking blood banks aren’t a new concept, having originated during World War I when transporting injured soldiers for life-saving treatment couldn’t be done quickly enough. The approach has been called a “buddy transfusion” or direct donor-to-patient transfusion and was pioneered during WWI. Although it fell out of practice decades ago due to safety concerns, it’s now possible again thanks to blood screening technologies.
It’s also necessitated by concerns that in a future war, evacuations and blood supplies on the battlefield could be disrupted by an adversary contesting the airspace and making transporting critical supplies perilous.
During the recent training exercise, personnel were screened to determine blood-type matches or any disqualifying diseases. Once approved, they were taken to a medical tent to donate. The training transfusions took only minutes and resulted in a fresh supply of blood.
Kemeny said that while the walking blood bank was something done previously, it is still innovative since it had been out of practice.
The US Army has been reexamining the role of “walking blood banks” in battle for a few years now. For instance, in 2019, the XVII Airborne Corps and Armed Services Blood Program partnered to identify soldiers with the universal blood type O who could become immediate donors on the battlefield.
The effort could save lives, especially in remote locations where every second to treat wounded soldiers counts, personnel said at the time.
There have been other experiments as well. In early 2024, for example, Army medics participating in a large-scale joint exercise in Alaska told Business Insider about the difficulties of treating injuries in cold-weather environments like the Arctic. Blood transfusions in particular were complicated by the low temperatures, leading personnel to experiment with walking blood banks.
And in Ukraine, a Danish-Ukrainian initiative is mobilizing a “walking blood bank” that taps both civilians and soldiers as donors. The program helps offset severe blood shortages caused by Russia’s full-scale invasion, which has driven up demand from mass casualties.
For the US and its allies, the return of walking blood banks as a concept is a clear reminder that future conflicts may demand not just new weapons, but also old practices reborn to keep soldiers alive when the skies aren’t safe.
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