Availability and safety of blood transfusion during humanitarian emergencies

Abstract

Background: Availability and safety of blood transfusion is a major concern in countries affected by humanitarian emergencies. These emergencies increase demand for blood transfusion and make its delivery challenging and complex. Nevertheless, there is a lack of information on emergency preparedness and response capacity of blood transfusion services and on the challenges in meeting patients' needs. Aims: To assess availability and safety of blood transfusion during humanitarian emergencies. Methods: We searched PubMed and Index Medicus for the World Health Organization Eastern Mediterranean Region for data on availability and safety of blood transfusion during humanitarian emergencies. We also gathered information through a survey and during a regional consultation in Tunisia. Results: We found 24 publications on disaster from 5 countries in the Region and 16 publications on disaster preparedness and blood transfusion in casualties and severe trauma outside the Region. However, none dealt with availability and safety of blood transfusion during humanitarian emergencies. Armed conflicts and terrorism, flooding and earthquakes are the most frequent emergencies with 10-85% of the injured requiring blood transfusion. There are gaps in emergency preparedness and response, including human resources, transport and cold chain, supply of consumables and maintenance of equipment, power supply, and finances. Conclusions: There is a need to integrate blood transfusion services in the overall national emergency preparedness and response, and provide assistance to affected countries to address identified gaps. Recommendations for individual countries need to be tailor made, along the lines of the regional strategic framework for blood safety and availability.

Effect of Massive Transfusion Protocol on Coagulation Function in Elderly Patients with Multiple Injuries

“…At this time, the systemic blood will be redistributed, accompanied by poor local microcirculation, gastrointestinal mucosa vasoconstriction, lactic acid increase, and tissue ischemia and hypoxia, inducing systemic inflammation [17,18]. Moreover, the release of massive inflammatory mediators will further damage the impaired vascular endothelial cells, which leads to platelet aggregation and the synthesis and release of other coagulation factors, aggravating microcirculation disorders and forming a vicious circle [19,20]. In the past, rapid transfusion of red blood cells and crystalloid solution was the principle for the treatment of multiple injuries combined with massive bleeding, but the replenishment of coagulation factors and platelets was ignored, which could easily induce coagulopathy [21].…”

Moving beyond informal action: sustainable energy and the humanitarian response system

“…In Yemen, fuel shortages have caused several health-related challenges because hospitals and drug manufacturers are unable to operate without electricity (Burki 2016 ). Furthermore, as part of a systematic review investigating the availability and safety of blood transfusions during humanitarian emergencies, Abdella, Hajjeh and Sibinga ( 2018 ) found that a reliable power supply was one of the major challenges associated with maintaining the availability and safety of the blood supply system. While no data could be found for humanitarian contexts, estimates in the development literature suggest that 60% of refrigerators used to store vaccines and medications face unreliable electricity supplies (Gavi Alliance 2012 ).…”

Availability and safety of blood transfusion in low‐ and middle‐income countries

“…However, to more fundamentally address gaps in ensuring sustainable availability of and access to transfusion safety, we recommend the exemplary practical initiative developed by the WHO Eastern Mediterranean Region extending the global priority list of applied research questions with the following relevant themes: regulatory framework, governance and leadership; quality system management; logistics and epidemiology of demand and supply; and at the operational level, cold chain and transportation important for adequate accessibility. These aspects are the essence of the WHO “Guidelines on management of blood and blood components as essential medicines.” These WHO guidelines are intended to provide a common framework for establishing a sustainable regulatory oversight of blood and blood components as essential medicines for clinical use, a way forward toward availability and safety of blood transfusion in particular in low‐ and middle‐income countries.…”