Transfusion Service and Blood Banking in Natural Disasters

Abstract

Natural disasters are unpredicted events that erupt abruptly and are characterized by mass casualties and failure of infrastructure. The damage in such cases depends on two main factors, i.e., the magnitude of the natural event and human behavior. Collapse of houses and public facilities often results from non-adherence to building standards. Such a disaster is an ultimate test to executive capabilities of the community and authorities. Its successful management depends on efficient preemptive organization, including application of standard operating procedures (SOP) at both regional and state levels. Previous mega disasters have demonstrated that blood demand in such events increases only moderately, if at all, so that it may be easily covered by regional or central blood supply. Severely wounded patients require about 8 units of blood; however, these patients comprise about 5% of casualties that need blood transfusion. In cases when no electricity is available, most injured patients requiring emergency surgery would be airlifted to uninvolved areas and only minimal stock of blood products should be kept in the involved area. Fibrinogen and fresh frozen plasma are currently available as freeze-dried products which may be kept in the room temperature, not requiring refrigeration. The most important factor for maintaining adequate blood product supply is having a national or regional voluntary, non-remunerated blood donation system and appropriate SOP that are periodically tested. Collection of blood products beyond demand at time of such events is usually unnecessary and wasteful.