FORT BENNING, Ga., (May 27, 2015) -- The 75th Ranger Regiment has been working toward incorporating the use of fresh whole blood into the arsenal of Rangers pre-hospital providers in combat."There are risks involved with giving FWB in a pre-hospital setting given the potential for transfusion reaction and transfusion transmitted disease; however, the benefits outweigh the risks," said Andrew Fisher, physician assistant, 75th Ranger Regt.Fisher said the safest way to administer FWB in the pre-hospital setting, where the risk of error in matching donor and recipient blood types is highest, is to screen Type O universal donors before the battlefield."By identifying universal donors, the medic can eliminate several steps in the blood transfusion process as well as eliminate a significant amount of equipment, allowing for a transfusion on target to start within 15 minutes of the call for blood," Fisher said.Fisher explained the process of identifying universal donors."The protocol is designed where the universal donor will be identified and screened upon arriving at the unit. A roster is created for each company, and if there is a need for blood, the medic and leaders within the platoon will call for blood."The 75th's Ranger First Responder program is a two-day course that teaches the treatment for three preventable causes of death on the battlefield. They are massive hemorrhaging (bleeding), a tension pneumothorax (air in the chest cavity) and an airway obstruction."It takes a specially selected non-medic, who has recently passed the Ranger First Responder Program and shows an inclination for medicine to be selected into the Advanced Ranger First Responder program," Fisher said.The A-RFR is trauma focused, able to assist the Ranger Combat medic and perform many difficult tasks and procedures. The training allows the A-RFR to better assist a combat medic or perform advanced medical responder care in extreme emergencies."The idea of teaching the advanced first responders the FWB transfusion will undoubtedly save lives," Fisher added.The course is 10 days in length and includes day and night training and covers anatomy and physiology, trauma skills and procedures, and pharmacology. The main focus is on cardiovascular, respiratory, musculoskeletal, gastrointestinal, and neurological systems."The A-RFR program bridges the gap of non-medical and medical personnel for the Regiment," Fisher said. "By training the non-medic in the FWB donor collection procedure, the medic is able to focus on other advanced procedures and treatments like junctional tourniquets or (tranexamic acid)."This effort is in collaboration with the Army Institute of Surgical Research and the Armed Forces Blood Program."We are changing the approach to hemorrhagic shock in combat wounded Soldiers with the FWB protocol and this will help close a gap in pre-hospital combat resuscitation." said Fisher. "It is because of the command directed emphasis on medical training that the Regiment has had no preventable deaths on the battlefield in the last 13 years. This is no small feat for an infantry unit, let alone an infantry unit who has had a minimum of one-third of its personnel deployed since October 2001."