Thursday, September 23, 1999
Blood at seriously low level
Hoxworth's supply is under 50%
BY TIM BONFIELD
The Cincinnati Enquirer
Greater Cincinnati's blood shortage is serious enough that the local blood bank could run dry in a hurry if area hospitals have one more bad week.
On Wednesday, the first day of the third emergency blood appeal of the summer, the Hoxworth Blood Center started the day with 310 available units of type O blood — the most commonly used type. That's less than half of what Hoxworth considers a proper daily inventory.
Such a low level makes the blood bank people nervous because they know how quickly the 25 hospitals served by Hoxworth can run through blood.
Last week, one local hospital used more than 360 units on just seven patients, said Hoxworth spokeswoman Marsha Terry. Five trauma cases required 243 units. A liver transplant patient needed 41 units. Another surgical patient used 77 units.
“All it takes is one or two big trauma cases and we're in trouble,” Ms. Terry said.
Another disturbing sign: After declaring emergency blood appeals in June and August, early response to the latest call for donors was running flat. As of Wednesday afternoon, collections were about 100 units behind the first day
of the August appeal, Ms. Terry said.
That means the next few days will be a white-knuckle ride for Hoxworth, local hospitals and patients who need surgery.
Even a strong response during the first few days of the emergency appeal won't eliminate the short-term risk. Blood donated Wednesday won't be available for patients until Friday because it takes about 48 hours to complete safety testing, Ms. Terry said.
Area hospital managers are watching the situation closely.
“Right now they're talking in surgery about what to do,” said Dr. Thomas Panke, medical director of laboratory services at TriHealth, which manages blood supplies for the high-volume surgery departments at Bethesda North and Good Samaritan hospitals.
“One big emergency at any of the hospitals could be enough to make that hospital unable to handle the next emergency that comes in. That's a very nerve-wracking situation,” Dr. Panke said.
If blood supplies continue to dwindle, Hoxworth will be forced to ask area hospitals to cancel or postpone elective surgeries so that blood can be saved for emergency trauma use.
Delaying an elective surgery may not sound so bad — until you realize that elective surgery goes far beyond optional treatments like liposuction.
Technically, nearly all surgery is “elective” because the patient isn't likely to die that day if the surgery isn't performed. That means most heart bypass operations and tumor-removal surgeries are “elective” even though the patient's condition is life-threatening.
Dr. Panke said people might not understand that during blood shortages, it isn't the minor surgeries that get delayed first, it's the big ones.
The surgeries that get bumped are the ones that are most likely to immediately require 30, 50 or 70 units of blood if a complication occurs. That includes open-heart surgeries, colon cancer surgery, and lung cancer cases.
Typically, surgeons prefer to operate within a few days after diagnosing such cases — sometimes even the same day — because delays only increase the risk to the patient.
For example, there's no way to predict whether a person who needs a heart bypass will end up dying of a heart attack while waiting for surgery, Dr. Panke said.
Hoxworth's seven neighborhood donation centers will be open extended hours through Monday, except Sunday. For an appointment, call 451-0910.
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