The victim had been stabilized, a tourniquet was applied to his left leg to stem a massive hemorrhage from the partial amputation that occurred during a motorcycle crash. The first responder on the scene had used a military-style first aid kit to treat the man’s wounds and prevent any more blood loss.  That was the good news.

Due to the remoteness of the area, the nearest ambulance crew were volunteer firefighters and EMT’s. The 9-1-1 dispatcher had advised that help would be on the way, estimated time of arrival was twenty to thirty minutes. Although he was no longer bleeding, the victim of the crash had lost a great deal of blood and was starting to go into shock; hypovolemic shock.

Common Occurance

Victims of traumatic injuries often survive the initial incident but then succumb to death due to massive hemorrhage and shock. Many who survive at the scene and are transported to an ER will still die due to complications developed from irreversible hemorrhagic shock. Irreversible shock occurs when the internal organs fail and cannot be revived.  It is accepted that a loss of 40 percent of the total blood volume is lethal due to the affects of irreversible shock on the organs.

The Missing Piece of the TCCC Puzzle

In Tactical Combat Casualty Care, troops are trained to perform self-aid and buddy-aid in the event of a traumatic injury. The primary purpose of the training is to give every trooper the knowledge and then the gear to stop-gap a life-threatening injury while they are awaiting the arrival of medical professionals and specialized equipment.

Without a doubt, the TCCC program can be declared a success as innumerable victims of trauma have been saved where they would likely have perished a decade or so prior. TCCC graduates are taught to stop massive bleeding, maintain an open airway, prevent death from a tension pneumothorax and properly bandage and cover open wounds and holes in the chest cavity. All this can be done with a basic kit that any trooper can carry in their pack or on their load-bearing gear.

The one missing piece of the puzzle is fluid; front line troops don’t carry bags of IV fluid or whole blood. Even if they did, starting and maintaining an IV during an active combat situation is problematic at best.

Up to this time, TCCC instructors and students simply had to be satisfied that stopping the bleeding and keeping the airway open was the best they could hope for minus a fully trained and equipped medical team. That was the case up until now.

Win Guns, Gear, and Training

Mechanical Blood Volumizer (MBV)

Originally developed to be used in bloodless surgery on limbs, the Mechanical Blood Volumizer or MBV is a medical device that can be carried in a pack or kit and applied to victims of trauma at the base level. Looking like a big Olive Drab colored donut, the MBV is placed on the trauma victim’s limb (leg or arm). The rubber donut puts even pressure onto the limb as it is “rolled” from the end up toward the torso.  All of the blood in that limb is forced into the core and can be used to stabilize the critical organs.

Benefits of the MBV use in the field include:

  • Reduction of physiological demand on cardiac output.
  • Removal of blood from the limb may to increase venous return
  • Increase systolic/diastolic pressure and stressed volume

Skeptics need to understand that bloodless surgeries, where the blood flow is completely cut off from the limb, occur every single day all over the world. Human limbs are very tolerant of blood restriction

  • 120-minute tourniquet time without complications
  • Over 500,000 usages in orthopedics to date with zero serious complications.

Personal Blood Banking

An emergency room physician who taught this author how to use the MBV explained it to me like this. “Think of the MBV as personal blood banking. The average adult has 500 ml of blood in each leg. By applying the MBV you are forcing 500 ml of usable blood from the limb where it is non-critical to the torso where it is absolutely critical to prevent irreversible shock.”

The doctor continued, “Even when the patient arrives in the ER, we don’t have a rack of perfectly matched blood sitting there waiting to be pumped into them, it takes time to get outside blood into the patient’s body. The use of an MBV buys us time, time that could be the difference between saving the patient’s life or losing them to hypovolemic shock.”

How to Use the MBV

1 Over the Heel

Getting the MBV over the heel is the toughest part of application.

Grab both handles and start rolling the MBV up the leg.

Grab both handles and start rolling the MBV up the leg.

Roll the MBV up to the groin.

Roll the MBV up to the groin.

Tie off the handles to keep the MBV from rolling back down.

Tie off the handles to keep the MBV from rolling back down.

As for medical qualifications to use the MBV, it was explained that any person qualified to apply a bandage to a patient can put on the MBV. The instructions are printed on the packaging but it is always better to get first hand training from a qualified teacher.

An MBV is applied after all of the critical steps in TCCC have been taken. Stop a massive hemorrhage, ensure that the patient has an open airway, check for breathing issues, bandage open wounds.

To apply the MBV

  1. Remove the shoes or boots from the patient
  2. Position the MBV “donut” hole over the toes with one handle up and one handle down toward the heel.
  3. Push the MBV down over the foot
  4. Use the bottom handle to pull the MBV over the heel (this is the toughest part of the application)
  5. Position yourself on the side of the patient at their waist level and pull the handles, one in each hand
  6. Deliberately roll the MBV all the way up to the patient’s groin
  7. Tie off the handles to prevent the MBV from rolling back down
  8. If possible, take a moment to note the time of application for the benefit of the ER personnel

Parting Thoughts

For those trained in TCCC and similar traumatic life-saving techniques, the benefits of the MBV should be obvious. Having an easy to use, relatively inexpensive and conveniently carried tool to use the patient’s own blood to keep them alive cannot be argued against. The MBV kit comes in a sealed package with two units.

Detailed information about the Mechanical Blood Volumizer can be found at

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