Submitted by: Pradeep K. Bhagat, M.D. and Ila Peterson, M.D.
We received a communication from the Penn-Jersey American Red Cross on 3-16-2020 that, in part said the following: “Dear Transfusion Service Partner, Already the American Red Cross is experiencing the adverse effects of the coronavirus pandemic (COVID-19) on our blood collection operations. With a rapidly increasing number of blood drive collections across the country, the impact to the national blood supply is inevitable. We are steadfast in our efforts to recruit and collect blood despite these ongoing challenges; however, the volatility of the situation requires that we act now to safeguard the anticipated limited supplies.”
At MLH the Blood Banks will take the following steps to insure the continued access to blood to those most in need. We believe that delaying elective surgeries when possible particularly on the Cardiovascular and Orthopedic Surgical Services until after the coronavirus crisis has subsided and blood product inventories are normalized will be of greatest help. Other measures include:
- Verifying that the patient is ready to be transfused before the blood product is picked up or sent by pneumatic tube. RBCs, platelets and plasma are wasted when a patient has a fever, no IV access or has not consented to transfusion and there is a delay in returning product to the blood bank once issued.
- For stable non-emergent patients with orders for 2 or more units of RBCs to be issued, units will be issued one at a time; the patient should be reassessed to see if an additional is required.
- We will be moving products between hospitals to limit outdating. We will not be stocking blood products on the shelf for “just in case” scenarios.
- ASAP we will switch from type O RBCs to type specific RBCs in emergent or massive transfusions.
- Expect out of type platelets. We will be ordering “any type” platelets from the Red Cross. PAS and 100% plasma platelets will be used interchangeably.
- We will be utilizing the one unit rather than 2 unit platelet transfusion strategy for non-bleeding adult oncology patients (Gehrie et al. Vox Sang 2019; 114: 517-22)
- For any coolers that go out and are returned with product to the Blood Banks, the Medical Director will be notified immediately to get permission to return the RBCs with white “safe t vues” and cold plasma into the refrigerated inventory. Platelets are to be returned at room temperature. It is paramount that coolers with product be returned ASAP once it has been determined that the product is not needed for transfusion.
8. Reduce products for holds e.g in OR setting.