Massive transfusion on the combat field using autonomous drones: A case report.

Background: Hemorrhage is a leading cause of preventable deaths in combat settings, requiring rapid blood transfusion to improve survival. While the feasibility of drone-assisted medical logistics has been explored, its practical application in battlefield transfusion remains unreported.

Study design and methods: This case report describes the first documented massive transfusion in a combat environment using an autonomous unmanned aerial vehicle (UAV). A 27-year-old soldier sustained severe lower limb injuries from an improvised explosive device explosion and developed hemorrhagic shock in a remote battlefield location where adverse weather conditions prevented immediate evacuation. In response, 6 units of whole blood and 2 units of fresh frozen plasma were transported via UAV, enabling prehospital transfusion under telemedicine supervision.

Results: The UAV successfully delivered blood products on two consecutive flights, ensuring early resuscitation and stabilization despite delayed evacuation. The casualty's vital signs improved post-transfusion, and surgical interventions were successfully performed following hospital admission. This case demonstrates the feasibility of drone-assisted blood product transport in prolonged field care scenarios.

Discussion: To our knowledge, this is the first reported case of a combat casualty receiving a UAV-facilitated massive transfusion in an operational setting. While UAV-based medical logistics offers a rapid and reliable alternative for remote trauma care, challenges remain in regulatory implementation, blood product stability, and integration into standardized protocols. Further controlled studies are needed to optimize UAV-assisted transfusion strategies and their potential expansion into civilian and disaster response settings.