Thread by @TransfusionWM

This week, NBTC released an updated Red Cell Shortage Plan. Why is it needed and what does it say? Keep reading for some #blooducation @PBM_NHS

Blood donation levels are falling consistently due to reduced donor activity. At the moment, blood stocks look good because elective work has ceased in most hospitals and NHSBT are working to increase donations. But it is anticipated soon demand will exceed supply.

Every hospital needs an Emergency Blood Management Plan in order to respond to notifications from @NHSBT. There are 3 phases;
•Green: supply meets demand
•Amber: Reduced availability of blood for a short or prolonged period
•Red: Severe, prolonged shortages

National stocks are monitored daily and can be seen here hospital.blood.co.uk/business-conti…

NHSBT aim to keep 6 days of stock for red cells.
At how many days’ stock does NHSBT issue the amber alert?

The amber alert is issued at 2 days’ stock. This means that stocks are already significantly reduced at this point.

To whom is the alert issued?

The alert comes to the transfusion laboratory manager

Amber/Red can be called on

The amber or red phase can be called on any group, any component. Most commonly it is called for A neg platelets and O neg red cells

When the amber/red phase are called the emergency blood management group should be convened. This group needs representation from the medical director, operational and risk management, key clinical users and the hospital transfusion team.

The EBMG provides strategic guidance and makes arrangements to manage appropriate use of blood in each operational phase. It is essential that the EBMG have senior hospital management support i.e. from the Chief Executive and Medical Director to ensure their effectiveness.

They, or a key group of individuals, should meet daily during shortages to review necessary actions

Suggested measures for preserving stocks: amber (most hospitals are already doing these)
•Review transfusion triggers
•For pts w high needs, liaise with lab/haem cons
•Reduce reservation period
•Consider temperature loggers in boxes to reduce wastage
•Reduce stock

Preserving stocks: red phase
•Review stock levels
•All requests for blood components to be reviewed by lab/haem cons to minimise inappropriate requests
•Remove red cells from remote fridges, except flyers
All changes to be communicated to clinical and management teams

NHSBT have plans to increase supply at times of shortage, such as calling more donors, extending working hours of manufacturing and donor sessions, increasing monitoring and mobilisation of stock around the country. These measures are already taking place.

During shortages NHSBT will monitor blood usage in hospitals. Where hospitals are unable to meet the recommended reductions in stockholding and use, the haematologist or laboratory manager will be expected to discuss with an NHSBT consultant, or PBM practitioner.

When returning to green it should be remembered that increase in elective work may place further demand on blood supplies.

This was a quick run through the EBMG. How prepared are you? Do the relevant people in your trust know their roles? Easter will be a particularly challenging time, especially for platelets. Make sure you are prepared!

Shortage plans can be found here transfusionguidelines.org/uk-transfusion…

Thank you for reading this far. I know everyone is working really hard to make sure our patients get the best care 👏👏👏