Prolonged Field Care Podcast PFC Podcast: Walking Blood Bank - Mastering ROLO Transfusions in Combat
Oct 23, 2025
A seasoned medic shares a gripping story from a night raid in Afghanistan, highlighting the intense challenges of casualty management under fire. The conversation emphasizes the critical importance of having a blood supply readily available and the necessity for rigorous training and preparation. Common mistakes, such as inadequate medical supplies, are discussed alongside the need for effective communication and teamwork in high-pressure situations. Brad stresses that repetition in training can lead to flawless execution during emergencies.
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Mass-Casualty Night Raid With Major Pelvic Trauma
- Brad described a night raid where an explosion caused multiple casualties including a patient with catastrophic pelvic and limb damage.
- He applied tourniquets, junctional control, TXA, and started blood while working under fire to stabilize the casualty.
Emergency Surgical Airway Under Fire
- Brad treated a third casualty with a penetrating neck wound and performed an emergent surgical airway under fire.
- He balanced airway interventions with blood resuscitation and analgesia while the scene remained contested.
ROLO Activated Mid-Engagement To Sustain Life
- After exhausting mission blood, Brad initiated a ROLO (walking blood bank) using an AFR donor nearby and Y-tubing with a pressure infuser pump.
- The team used ROLO units to maintain radial pulses while moving through multiple ambushes to an HLZ and into flight care.