Civilian walking blood bank emergency preparedness plan

Holcomb, John B; Spinella, Philip C; Apelseth, Torunn Oveland; Butler, Frank K; Cannon, Jeremy W; Cap, Andrew P; Corley, Jason B; Doughty, Heidi; Fitzpatrick, Michael; Goldkind, Sara F; Gurney, Jennifer M; Homer, Mary J; Ilstrup, Sarah J; Jansen, Jan O; Jenkins, Donald H; Marques, Marisa B; Moore, Eugene E; Ness, Paul M; O'Connor, Kevin C; Schreiber, Martin A; Shinar, Eilat; Sloan, Steve; Strandenes, Geir; Stubbs, James R; Taylor, Audra L; Ward, Kevin R; Waltman, Elizabeth; Yazer, Mark

BACKGROUND: The current global pandemic has created unprecedented challenges in the blood supply network. Given the recent shortages, there must be a civilian plan for massively bleeding patients when there are no blood products on the shelf. Recognizing that the time to death in bleeding patients is less than 2 h, timely resupply from unaffected locations is not possible. One solution is to transfuse emergency untested whole blood (EUWB), similar to the extensive military experience fine-tuned over the last 19 years. While this concept is anathema in current civilian transfusion practice, it seems prudent to have a vetted plan in place. METHODS AND MATERIALS: During the early stages of the 2020 global pandemic, a multidisciplinary and international group of clinicians with broad experience in transfusion medicine communicated routinely. The result is a planning document that provides both background information and a high-level guide on how to emergently deliver EUWB for patients who would otherwise die of hemorrhage. RESULTS AND CONCLUSIONS: Similar plans have been utilized in remote locations, both on the battlefield and in civilian practice. The proposed recommendations are designed to provide high-level guidance for experienced blood bankers, transfusion experts, clinicians, and health authorities. Like with all emergency preparedness, it is always better to have a well-thought-out and trained plan in place, rather than trying to develop a hasty plan in the midst of a disaster. We need to prevent the potential for empty shelves and bleeding patients dying for lack of blood.