Assessment of the urgency and deferability of transfusion to inform emergency blood planning and triage: the Bloodhound prospective audit of red blood cell use.
BACKGROUND
Careful planning is essential to ensure blood availability during shortages. Triaging supply is one proposed strategy; however, few data concerning the urgency of transfusion are available to inform planning. This study sought to determine the proportion of red blood cells (RBCs) used for clinically urgent indications.


METHODS
A total of 5132 RBC units were randomly selected at point of production and distributed into general statewide inventory over a 9-month period. These selected units carried case report forms, for completion at the point of hospital issue for transfusion. Completed forms were returned to the blood service for collation and analysis, capturing information on indication and clinical urgency of supply, including use for potentially deferrable elective surgery.


RESULTS
Data from 5052 RBC units indicated that 95.6% were transfused. Approximately one-third of transfused units were used to support surgery, one-third for hematology/oncology, and one-third for other medical and miscellaneous indications. Where used for surgery, 25.7% (95% confidence interval [CI], 23.4%-28.0%) were for elective procedures, although urgency of surgery was unknown in 17.1% (95% CI, 15.2%-19.2%) of cases. Supply for nonurgent medical indications and elective surgery only accounted for 9.8% (95% CI, 9.0%-10.6%) of use, with 53.4% (95% CI, 52.0%-54.8%) of RBCs required within 24 hours.


CONCLUSIONS
The majority of RBCs are transfused with a high degree of clinical urgency, with only a minor proportion required to support elective surgery.
Shortt
Jake
J
Transfusion Medicine Services, Australian Red Cross Blood Service, Australia.
Polizzotto
Mark N
MN
Waters
Neil
N
Borosak
Marija
M
Moran
Martine
M
Comande
Mary
M
Devine
Alexandra
A
Jolley
Damien J
DJ
Wood
Erica M
EM
D001803:Blood Transfusion / Q000706:statistics & numerical data*; D004630:Emergencies; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D006801:Humans; D014218:Triage