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Blood shortage strains hospitals | Modern healthcare

Some hospitals have had to cancel surgeries and redirect emergency care due to falling national blood supplies.

According to group purchasing organization Vizient, only about half of hospital blood orders are fulfilled. Some rural facilities have been forced to triage aid, giving priority to those receiving treatment and those not.

“Some of my colleagues in the countryside do it daily,” said Dr. Claudia Cohn, medical director of the blood bank at the University of Fairview Minnesota Medical Center. M Health, a 15-hospital system based in Minneapolis, has been forced to slightly reduce its standard inventory levels and avoid delays or cancellations of treatments.

“Reducing the standard supply in rural areas is a much more frightening thing. If there is a car accident or someone has gastrointestinal bleeding in the middle of the night, it could be a life situation,” Cohn said.

According to the American Blood Centers, more than a third of community blood centers report having a one-day or less supply of blood. daily update from 59 banks. Centers with three or more days of supply have enough supplies to meet normal operating needs, but more than two-thirds have two days or less of blood available.

One hospital in Raleigh, North Carolina, recently completed 10 units of type O blood after trauma to several patients, said Akiva Faerber, senior head of Vizient’s laboratory and blood counseling. The stock of blood O in hospitals, which used to be 20 units, has fallen to seven, he said.

“Many of our Vizient members have called me over the past three weeks in desperation to try and get additional product,” said Faerbeer, who described the current shortage as the worst in his 47 years in the industry. “Many hospitals ask for Os, but the Red Cross regularly measures out planned orders. Some of them have been reduced by as much as 60%,” he said.

Harbor-UCLA Medical Center, which is owned and operated by Los Angeles County, temporarily closed its trauma center to new patients for a few hours this week.

“This is already having a very negative impact on patient care, from canceling elective procedures in an attempt to conserve scarce resources to [emergency departments] blood leaks,” said Christopher Godfrey, CEO of Bloodbuy, which sells software to facilitate blood distribution. the negative impact this has had on blood donation across the country. This is indeed a public health crisis and all indications are that it will likely get worse before it gets better.”

The COVID-19 pandemic has led to a decline in blood donation for several reasons. Among them is that free offices and schools mean fewer donations. Blood providers, like the rest of the healthcare industry, are also experiencing staffing challenges.

Blood donation down 10% since March 2020, Red Cross data show. Due to the pandemic, illness, weather conditions and staffing, the number of blood transfusions in colleges and high schools has dropped by 62%, according to the organization.

Many hospitals have once again had to postpone non-urgent surgeries as they struggle to keep up with the latest surge in COVID-19. This has helped conserve blood, but many institutions have adjusted or are considering adjusting their blood distribution protocols.

“This is the worst blood shortage in over a decade and poses a significant risk to patient care,” the Red Cross website says. “Doctors have been forced to make difficult decisions about who will receive blood transfusions and who will have to wait until more products are available. Donated blood and platelets are urgently needed to prevent further delays in vital medical procedures.”

Traditionally, clinicians default to transfusion when a patient’s hemoglobin is below 10 grams per deciliter. But many patients with levels between 7 and 10 grams per deciliter may not need a blood transfusion, according to recent research. research this suggests that one unit of blood rather than two may be safer.

Hospitals now advise patients to eat more leafy greens, nuts and other foods to boost their iron levels, and give them intravenous iron or RBC stimulants before surgery to reduce blood loss. Some use devices to store the cells that process blood during surgery.

“These measures are really important and should be part of the preoperative evaluation of hospitals,” Cohn said.

Clinicians are spending more time than before to determine if patients are stable enough and need a blood transfusion, and they are developing alternatives, Faerber said. “We are still behind the times in a more thorough assessment of the use of our blood,” he said.

Meanwhile, larger health care systems are doing better because they can transfuse blood between hospitals, as is the case with Adventist Health in Roseville, Calif., and its West Coast facilities, the spokesman said.

The University of Utah Health in Salt Lake City maintains an adequate supply of blood and has not had to delay treatment, as is the case with Memorial Hermann Health System in Houston and Froedtert Health of Milwaukee, according to the companies.

Edward-Elmhurst Health of Naperville, Illinois, has expanded its blood supply network to include supplies from Florida and New York, said Guy Diehl, blood bank manager at Edward Hospital.

“This is a testament to how hard the system is working,” Diehl said. “We would be happy if people could donate.”


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