The clinical need for a safe and effective oxygen-carrying resuscitative fluid when blood is not available is recognized by both civilian and military trauma surgeons throughout the world. Blood may not be immediately available in the following situations:

• At the scene of injury or disaster in civilian or military settings
• During transport to the hospital via ground or air ambulance
• In the operating room in the case of unplanned surgical hemorrhage
• In remote or rural settings, including hospitals, where blood may be in limited supply
• In situations where the needs of multiple, simultaneously injured patients may overwhelm a hospital’s inventory of stored blood
• In cases of inventory imbalance or inadequate supply
• In cases of incompatibility
• In cases of religious objection to blood