HMCS Ville de Québec pioneers Massive Blood Transfusion training

September 26, 2025 - Royal Canadian Navy

Estimated read time – 2:15

By: Captain Christine MacNeil

September 10 - HMCS Ville de Québec transited the Red Sea and Bab-el Mandeb Strait as they circumnavigated the globe while deployed on Operation HORIZON. Plans for this transit were not undertaken lightly, as this is considered one of the higher risk sea lanes. In typical CAF fashion, HMCS Ville de Québec hoped for the best but planned for the worst. One of these plans was to have a General Duty Medical Officer (GDMO) on board to augment the ship’s medical team for this portion of the voyage.

The GDMO, knowing that ship’s medical teams generally have limited experience handling blood, resolved to provide a unique training opportunity by planning a simulated Massive Blood Transfusion with the expired units of blood on board.

Working with Canadian Forces Health Services, he created a scenario that would establish a training standard for the future. Checklists and guidelines for safe handling of blood were incorporated, and the medical chain of command was enthusiastically supportive of this opportunity. Involved in the training were the volunteer casualty, the PA (or ship’s doc) and Paramedic (baby doc), as well as two volunteers from the Casualty Clearing Team, all overseen by the GDMO.

The scenario commenced with the ‘Casualty Casualty Casualty’ alarm sounding throughout the ship. The two Casualty Clearers were the first responders, and found the casualty with a (simulated) partially amputated wrist due to a hatch falling unexpectedly. The casualty was quickly assessed, then brought to sick bay for treatment. After a full assessment by the PA, it was determined a blood transfusion was necessary, and the team set up the ship’s sick bay set to conduct the (simulated) procedure.

After simulating the insertion of an intravenous (IV) device into the casualty, the blood was heated to the appropriate temperature using a blood warmer and infused into the patient while observing for any changes in their condition. An adverse reaction was observed, so the team had to quickly cease the transfusion and treat the symptoms. Once the patient was stable, the second bag of blood was brought out and the procedure repeated. With two bags of blood transfused (into an empty bottle, while the ‘IV’ was in the patient’s arm), HMCS Ville de Québec’s medical team became the first in Royal Canadian Navy history to conduct this training.

The addition of this training to the ship’s medical arsenal adds a new capability to the sick bay. The ability to transfuse blood into a hemorrhaging patient will extend the window between injury and evacuation to a higher level of care, a critical consideration when operating in remote and severe environments. HMCS Ville de Québec may have been the first to conduct this training, but with clear guidelines now in place and its benefits undeniable, it certainly won’t be the last.