Anemia strains hospital | Modern healthcare


Some hospitals have had to suspend operations and redirect emergency care when the national blood supply drops.

Only about half of the hospitals’ blood orders are replenished, according to the group purchasing organization Vizient. Some rural institutions have been forced to triage care by prioritizing who receives treatment and who does not.

“Some of my colleagues in the countryside do it on a daily basis,” said Dr. Claudia Cohn, medical director of the M Health Fairview University of Minnesota Medical Center’s blood bank. M Health, a 15-hospital hospital system based in Minneapolis, had to reduce its standard equipment slightly and avoided postponing or interrupting care.

“Lowering your standard rural stockpile is a much scarier thing. If it’s a car accident or someone has a gastrointestinal bleeding in the middle of the night, it could be a life or death situation,” Cohn said.

More than a third of local blood centers report having a one-day supply or less, according to America’s Blood Centers’ daily update from 59 banks. Centers with three or more days have enough access to meet normal operating requirements, but more than two-thirds have two days of blood or less on hand.

A hospital in Raleigh, North Carolina, recently went through 10 units of type O blood after a trauma incident with several patients, says Akiva Faerber, Vizient’s senior rector for laboratory and blood consultation. The hospital supply of O-blood, usually at 20 units, dropped to seven, he said.

“Many of our Vizient members have been calling me for the past three weeks in desperation to try to get additional products,” said Faerber, who described the current shortage as the worst in its 47 years in the industry. “Many hospitals ask for Os, but the Red Cross measures out regularly scheduled orders. Some have been cut as much as 60%,” he said.

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

“It already has a profoundly negative impact on patient care, ranging from setting up elective procedures in an attempt to conserve scarce resources, to [emergency departments] on diversion “, says Christopher Godfrey, CEO of Bloodbuy, which sells software to facilitate blood distribution.” We are currently in the midst of an unprecedented blood supply crisis that has built up over several months, as a result of covid-19 and the negative impact it has had on blood donation throughout the country. It really is a public health crisis and all indications are that it will probably get worse before it gets better. “

The Covid-19 pandemic have depressed blood transfusions for several reasons. Among them is that vacant offices and schools mean fewer donation runs. Blood suppliers, such as the rest of the healthcare, also has staff problems.

Blood donation has decreased by 10% since March 2020, the Red Cross data show. There has been a 62% reduction in blood tests in colleges and colleges due to pandemics, illness, weather and staff, according to the organization.

Many hospitals have had to postpone non-emergency surgery once again as they struggle to keep pace with the recent rise in covid-19. It has helped save blood, but many facilities have adapted or are considering adjust their blood allocation protocols.

“It is the worst anemia in over a decade, which poses a worrying risk to patient care,” says the Red Cross’ website. “Doctors have been forced to make difficult decisions about who will receive blood transfusions and who will have to wait until more products become available. Blood and platelet donations are crucial to help prevent further delays in important medical treatments.”

Traditionally, doctors do not usually take blood transfusions when the patient’s hemoglobin value is below 10 grams per deciliter. However, many patients with levels between 7 and 10 grams per deciliter may not need blood transfusions according to the latest research which suggests that one unit of blood rather than two may be safer.

Hospitals are now telling patients to eat more leafy greens, nuts and other foods to increase their iron levels and give them intravenous iron or red blood cell stimulators before surgery to reduce blood loss. Some use cell-saving devices that recover blood during surgery.

“These measures are really important and must be part of the hospitals’ assessments before surgery,” Cohn said.

Clinics are taking more time than ever to determine if patients are stable enough or if they need transfusions, and they are developing alternatives, Faerber said. “We are still behind in terms of evaluating our blood use more carefully,” he said.

Meanwhile, larger health systems have fared better because they can transfer blood between hospitals, as is the case at Roseville, California-based Adventist Health and its West Coast facilities, a spokesman said.

The University of Utah Health in Salt Lake City has maintained an adequate blood supply and has not had to delay care, similar to the Memorial Hermann Health System in Houston and Froedtert Health in Milwaukee, according to the companies.

Edward-Elmhurst Health in Naperville, Illinois, has expanded its blood supply network and has received shipments from Florida and New York, says Guy Diehl, blood bank supervisor at Edward Hospital.

“It’s a testament to how hard the system works,” Diehl said. “We would love it if people could donate.”



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