{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T21:06:20Z","timestamp":1779483980400,"version":"3.53.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Exsanguinating hemorrhage is a leading cause of preventable death in combat. The Joint Trauma System prioritizes cold-chain stored whole blood (CCSB) as the resuscitation fluid of choice for combat casualties. However, in distributed maritime operations (DMO) and future large-scale combat operations (LSCO), significant overwater distances, cold-chain requirements, and limited access to aviation assets complicate blood resupply. This is similarly true in complex disaster environments. Unmanned aerial systems (UAS) offer a potential solution by providing long-range, low-risk, and cost-efficient delivery of blood products. This study evaluates the feasibility of using a Group 3 UAS for endurance-distance blood resupply and related missions in a simulated operational military environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Ten units of whole blood were collected from Sus domesticus and stored in citrated bags (CPD-A) at 1-6\u2009\u00b0C. Three simulated missions were executed using a Skyways V2.6 UAS equipped with a climate-controlled payload bay: Endurance resupply mission of 10 units (4.66 kg) flown 313 miles at 500 feet AGL in a racetrack course; loiter and on-demand resupply mission of 3 units (1.31 kg) launched from a simulated Role 2 site, loitered 30 minutes, and delivered to a Role 1 site on command; logistics exchange mission of non-climate-controlled payload containing 8.2 kg of medical and surgical supplies flown 120 miles for simulated recovery and reuse. Flight telemetry, payload temperatures, and mission timelines were recorded. Operational forces (U.S. Navy Corpsmen, Nurses, and Physicians) conducted payload transfers after minimal training. Ambient temperature range was approximately 69-74 \u00b0F (20.5-23.3\u2009\u00b0C) during the flight testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All flights were completed successfully. Whole blood remained within 1-6\u2009\u00b0C throughout Flights 1 and 2. Flight 1 lasted 6 hours and covered 313 miles, consuming 17.49 lbs of JP-5 fuel. The UAV transitioned between VTOL and fixed-wing pusher modes without incident. Payload transfers at Role 1 and Role 2 sites were performed effectively by personnel following brief on-site instruction. Flight 3 confirmed the platform\u2019s versatility in transporting non-temperature-sensitive medical equipment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study demonstrates the operational viability of Group 3 UAS to deliver CCSB over long distances exceeding previously documented UAV blood deliveries. It represents a significant increase in distance and capacity over current applications. The system offers significant advantages in contested environments by reducing risk to aircrew, operating on common fuel, and requiring minimal infrastructure. Payload-versus-distance tradeoffs remain the primary limitation, though offset by its low signature and fuel cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Group 3 UAS can safely and effectively transport whole blood over operationally relevant distances (&amp;gt;300 miles), supporting LSCO, austere, and disaster environments. This approach has implications for future military doctrine, humanitarian assistance, and disaster relief. Further evaluation with human blood in real-world operational theaters is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag231","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:45:54Z","timestamp":1778240754000},"source":"Crossref","is-referenced-by-count":0,"title":["Technical Evaluation of Drones and Employment Strategy for Blood Logistics in an Operational Military Environment"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6220-3829","authenticated-orcid":false,"given":"Joshua","family":"Kotler","sequence":"first","affiliation":[{"name":"III Marine Expeditionary Force , Okinawa, 96606,","place":["Japan"]},{"name":"Naval Biotechnology Group, Naval Medical Center Portsmouth , Portsmouth, VA 23708,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2722-6387","authenticated-orcid":false,"given":"Scott","family":"Hughey","sequence":"additional","affiliation":[{"name":"Naval Biotechnology Group, Naval Medical Center Portsmouth , Portsmouth, VA 23708,","place":["United States"]},{"name":"United States Naval Academy , Annapolis, MD 21402,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8444-8384","authenticated-orcid":false,"given":"Jacob","family":"Cole","sequence":"additional","affiliation":[{"name":"Naval Biotechnology Group, Naval Medical Center Portsmouth , Portsmouth, VA 23708,","place":["United States"]},{"name":"Uniformed Services University , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7025-0512","authenticated-orcid":false,"given":"Adam","family":"Brust","sequence":"additional","affiliation":[{"name":"Naval Biotechnology Group, Naval Medical Center Portsmouth , Portsmouth, VA 23708,","place":["United States"]},{"name":"Naval Hospital Pensacola , Pensacola, FL 32512,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1264-4052","authenticated-orcid":false,"given":"Kyle","family":"Checchi","sequence":"additional","affiliation":[{"name":"Naval Biotechnology Group, Naval Medical Center Portsmouth , Portsmouth, VA 23708,","place":["United States"]},{"name":"John H. 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