Plasma Stockpiling Critical

Plasma Stockpiling Critical

The article from the American College of Surgeons (ACS) Bulletin, titled “Trauma Surgeons Warn Civilian Systems Lack Readiness” (April 2025), highlights critical concerns about the preparedness of civilian trauma systems in the face of potential large-scale conflicts. Experts at the ACS Committee on Trauma (COT) 2025 Annual Meeting emphasized that current civilian infrastructure may be inadequate to handle the volume and complexity of casualties expected in modern warfare scenarios.

Dr. John H. Armstrong, Chair of the ACS COT Advocacy Pillar and retired U.S. Army colonel, pointed out that during two decades of conflict in Southwest Asia, approximately 50,000 service members were wounded. In contrast, projections for future large-scale combat operations estimate that the U.S. could face 1,000 casualties per day, reaching 50,000 in just 50 days. This stark comparison underscores the urgency for a robust national trauma care infrastructure, such as the proposed National Trauma and Emergency Preparedness System (NTEPS) 2.0, to manage such a surge in casualties.

Additionally, Dr. John B. Holcomb, a retired U.S. Army trauma surgeon, highlighted the evolving nature of warfare, noting the potential threats posed by technologies like drones. He advocated for the construction of subterranean healthcare facilities in combat zones to protect both patients and medical personnel.

The article also addresses the challenges faced by military surgeons in maintaining trauma readiness during peacetime. Retired Air Force trauma surgeon Colonel Jeremy Cannon testified before Congress, warning of a “systematic erosion” of medical readiness, with only 10% of military surgeons prepared for war in 2019, down from 17% in 2015. He emphasized the need for designated trauma centers staffed by military doctors to ensure they maintain the necessary skills.

Furthermore, disparities in trauma care access were discussed, particularly the concept of “blood deserts”—areas where emergency medical services lack the capability to provide blood transfusions in the field. Dr. Holcomb estimated that about 10,000 lives could be

saved annually if every U.S. ambulance carried blood, highlighting the need for policy changes to address these gaps.

The ACS COT’s 2025 Annual Meeting brought together over 700 participants from 45 countries, focusing on enhancing trauma care and education worldwide. The meeting also celebrated the 10th anniversary of the Future Trauma Leaders (FTL) Program, which provides training and mentoring opportunities for early-career trauma and acute care surgeons.

In summary, the article underscores the pressing need for systemic improvements in both military and civilian trauma care infrastructures to ensure readiness for future conflicts and mass casualty events.

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