The Oslo massacre 2011

Abstract

Background In terrorist attacks on July 22, 2011, seventy‐seven people were killed; 8 in and around the goverment buildings in downtown Oslo due to a huge bomb explosion, and 69 mostly young people due to shootings at Utøya; an island outside Oslo where there was an ongoing political youth camp. Thirthy‐one heavily injured patients were admitted to the Oslo University Hospital, Ullevaal that houses the trauma referral centre, and all except for one patient survived.Aims This report presents how we handled the disaster at the Department of Immunology and Transfusion Medicine that hosts the Blood Bank of Oslo.Methods Being the largest blood bank in Norway, we are supposed to have a stock of approximately 1750 units of packed red blood cells (PRBC) of all blood types at any time including a stock of minimum 80, and rather 130 units of blood type O RhD negative PRBC. But instead we had only 55 O RhD negative units when the terrorist attacks started. Since this was too low, we had to collect blood from already registered blood donors at our blood bank, and at the same time purchase units from the other blood banks. We had yet called a couple of donors, then an enormous flow of people who wanted to donate blood started. There were hundreds of people, a lot of them not registered from before. Chaos lasted several hours until the security guards gained control over the situation.Results The Blood Bank was well‐staffed with 28 biomedical laboratory technicians, nurses and doctors both on July 22 and 23, and collected blood from 220 donors. We bought also 80 units of PRBC from the other blood banks. Sixty units of PRBC, 14 platelet concentrates and 51 units of plasma were issued on 22 and 23 July, and during the first five days 84, 14 and 61 units, respectively. One of the major challenges was, already in the beginning, to estimate the blood requirements to come without knowing the dimensions of the disaster. This was necessary in order to decide how many blood units to purchase from the other blood banks and to collect from registered donors. Over‐collection could lead to massive discards of non‐used units, waste of money/resources, harm blood donor recruitment later, and cause loss of trust in the transfusion service. Discards stayed at a very low level. However, we may have hindered chaos due to hundreds of people who wanted to donate blood if we, in a much earlier phase, had communicated with media and announced at the social platforms that only our registered donors with blood type O RhD negative were needed.Conclusion In a real emergency, only units that are ready to transfuse can be used in life‐saving treatment, because it takes several hours from the collection of blood until the unit is ready for transfusion. Therefore blood banks need a stable supply of donors to maintain an adequate stock of blood at any time.