11/04/2026
The main maxim holds true: when bleeding, give blood.
But the availability of blood can be limited near the front, due not only to supply scarcity but also to disruptions in logistics. In these situations, plasma may be a useful adjunct.
Plasma is what the blood cells float in, but it is not just inert fluid. It is packed with c̲l̲o̲t̲t̲i̲n̲g̲ f̲a̲c̲t̲o̲r̲s̲. While resuscitating a bleeding casualty with crystalloid fluids like saline can dilute the blood’s remaining clotting factors and make bleeding harder to control, plasma replaces those factors while also supporting circulating volume. This may support the casualty’s ability to form clots. It will, however, still dilute the oxygen-carrying capacity of red blood cells.
Severe illness, such as trauma or infection, can also damage the inner lining of blood vessels - the glycocalyx - causing f̲l̲u̲i̲d̲ t̲o̲ l̲e̲a̲k̲ o̲u̲t̲ o̲f̲ v̲e̲s̲s̲e̲l̲s̲ into the surrounding tissues. Plasma transfusions may help protect this barrier.
Furthermore, it may be a preferred fluid to use in b̲u̲r̲n̲ p̲a̲t̲i̲e̲n̲t̲s̲. Large surface area burns cause massive fluid loss, and a major part of emergency burn treatment is ensuring adequate hydration. This extra fluid usually leaks out into tissues, causing massive edema. Plasma can likely be given at much lower volumes and support blood pressure because it does not leak out of vessels to the extent that crystalloids do.
Freeze-dried plasma is particularly useful in the field due to its l̲o̲n̲g̲ s̲h̲e̲l̲f̲ l̲i̲f̲e̲ a̲n̲d̲ e̲a̲s̲e̲ o̲f̲ t̲r̲a̲n̲s̲p̲o̲r̲t̲.
𝐓𝐨 𝐬𝐮𝐩𝐩𝐨𝐫𝐭 𝐭𝐡𝐢𝐬 𝐰𝐨𝐫𝐤, 𝐩𝐥𝐞𝐚𝐬𝐞 𝐜𝐨𝐧𝐬𝐢𝐝𝐞𝐫 𝐝𝐨𝐧𝐚𝐭𝐢𝐧𝐠 𝐭𝐨: donorbox.org/fm-winter-2026
