Prior to the founding of the ASBP, the military did not have a unified transfusion program. Blood and blood products were collected from military personnel exclusively during wartime. In peacetime and when wartime needs could not be met, blood was purchased from civilian agencies. When Pearl Harbor was bombed in 1941, the United States entered World War II with this contingency structure in place.|
It was during WWII, however, that the delivery of blood to the theater of operations underwent one of its chief advances. As casualties began to mount, demand overtook supply in the European theater. Our European allies took advantage of the blood banking system that was being developed for the U.S., but were largely focused on maintaining local blood collection and distribution. As allied troops pushed deeper into France and further from supply lines, a method had to be devised to get blood products to the front line. In 1944, the American military began to build up its airlift capabilities and blood was high on the list of items to be transported. Airlifting blood to forward locations proved to be a key innovation that changed the face of military blood delivery.
The military airlift became the vital link in getting blood supplies to hotspots throughout the Pacific theater. Forward bases received a constant stream of blood collected from troops stationed in Australia and New Zealand. During the battle for Okinawa alone, 20,000 units were funneled through a central blood bank in Guam and airlifted to advance bases using local air services. Roughly 12,000 Americans died taking the island and 60,000 more were wounded. Without sufficient amounts of blood in forward areas, U.S. forces would have lost thousands more.
Throughout WWII more than 825,000 units were collected in support of troops fighting around the world. Since it could be given to anyone regardless of blood type, only Type O negative blood was sent into combat zones. On the average, each surviving casualty required one unit of whole blood and one unit of plasma during treatment.
In September 1945, with the end of hostilities in World War II, the military began to downsize. In returning to a peacetime posture, the whole blood and plasma programs were quickly phased out.
During the years between WWII and the Korean War, the need for blood in military hospitals was met through individual hospital efforts. There were no plans, military or otherwise, to stockpile reserves of plasma for a national emergency. Indeed, had such a disaster occurred, there would have been no program to put into effect. The whole blood program may have disappeared entirely in the post-war period if not for the stimulus provided by civilian agencies.
While a prisoner in Thailand during WWII, a physician realized blood transfusions were indicated for several of the hospitalized prisoners. Without access to proper blood collection equipment, he had to improvise.
The physician soldered a fabricated dasher, cut from tin cans, to a hole in the lid of a Mason jar. A second hole was made to accommodate rubber tubing. As there was only one large gauge needle and one length of tubing, they had to be used for both donor and recipient. Since there were no anticoagulants, the only method to prevent clotting during collection was constant agitation of the blood.
Blood group compatibility testing was similarly crude. Dog tags were used to find prospective donors, after which drops of blood from donor and recipient were mixed on a glass slide as a final test. Despite these extremely adverse conditions, this physician found a way to make blood available for critically wounded troops.