How do I get an emergency civilian walking blood bank running?

Abstract

The shift toward using a transfusion strategy in a ratio to mimic whole blood (WB) functionality has revitalized WB as a viable option to replace severe blood loss in civilian health care. A military‐civilian collaboration has contributed to the reintroduction of WB at Haukeland University Hospital in Bergen, Norway. WB has logistical and hemostatic advantages in both the pre‐ and in‐hospital settings where the goal is a perfectly timed balanced transfusion strategy. In this paper, we describe an event leading to activation of our emergency WB collection strategy for the first time. We evaluate the feasibility of our civilian walking blood bank (WBB) to cover the need of a massive amount of blood in an emergency situation. The challenges are discussed in relation to the different stages of the event with the recommendations for improvement in practice. We conclude that the use of pre‐screened donors as a WBB in a civilian setting is feasible. The WBB can provide platelet containing blood components for balanced blood resuscitation in a clinically relevant time frame.

From battlefront to homefront: creation of a civilian walking blood bank

“…The idea of a WBB was initially reported during World War I when transfusion medicine was in its early stages . While blood transfusions were first performed in the early 20th century, the practice of blood banking and blood product storage was not implemented until World War II.…”

“…The idea of a civilian WBB was also described in the mid‐20th century to address limited blood product availability . However, a shift in blood bank practice from WB to CT and the HIV epidemic decreased enthusiasm for WBBs . Military conflicts in Afghanistan and Iraq renewed interest in the WBB .…”

“…The creation of a structured military‐civilian WBB in Norway was established in 2010 between the Norwegian Naval Special Operation Commando and the Department of Immunology and Transfusion Medicine at Haukeland University Hospital in Bergen, Norway . The Bergen model was adapted from the military WBB .…”

“…The Bergen model was adapted from the military WBB . The goal of the collaboration was to establish a WBB for civilians in the event of an MCI and also to have WB and freeze‐dried plasma available for military conflicts . WB can be obtained from established or pretested blood group O donors with a low titer of anti‐A and anti‐B.…”

“…As blood resources become depleted, donors are notified and advised to report to the blood bank to donate. Coordination between the blood bank director and clinicians is imperative to obtain a sufficient supply of blood without generating waste . WB is available within 1 to 4 hours.…”