Thread by @TransfusionWM

Next up Heidi Doughty talking on transfusion support for mass casualty events and updated guidance. Sadly a very important part of our work #F2FNHSBT

Review article in Vox Sanguinis Ramsey et al. onlinelibrary.wiley.com/doi/abs/10.111…

Although some patients need MHP, recent disasters have shown a couple of units used per patient. But relates to GSWs rather than IUDs... No clear answer #F2FNHSBT

Repeat visits to theatre often required with ongoing transfusion requirements. Important to get it right first time #F2FNHSBT

Not just mass casualty incidents but all emergency preparedness e.g. reduced supply from weather/pandemic flu and so on. Have you read your hospital's plan? Is blood management included? #F2FNHSBT

TPs play a key role in supporting clinical staff #F2FNHSBT

We have run table top and mock exercises locally. Very useful to identify what works and what doesn't #F2FNHSBT

Also need a stand down plan. Normal service can't resume straight away... #F2FNHSBT

Lots of resources from over the pond here asprtracie.hhs.gov/technical-reso… #F2FNHSBT

Issues with patient identification and numbering always topical. Sequential numbering is not safe #F2FNHSBT

NHS England guidelines on track for release over the summer. Clinical Guidelines for Major Incidents and Mass Casualty Events #F2FNHSBT

Triage of patients is important but difficult. P1/2/3 system may be obsolete. P1s to MTCs and P2s to TUs. Most hospitals will get patients, even if not a MTC. Everyone needs a plan! Check your regional MI plan to see what your hospital is assigned #F2FNHSBT

Principles of MHP are maintained but need modifications. Substitutions need to be clear and available. As always communication and portering need to be prioritised #F2FNHSBT

Biggest risk is ABO incompatibility. RhD and kell prioritised for women <50y #F2FNHSBT

Use of red cells in mass cas events is bimodal. Median is 2 units but a few patients will need far more #F2FNHSBT

Danger of overordering is real and will cause harm unless we have clear plans #F2FNHSBT

How to manage additional donors? Peak in new donors at about a week. Supply chain cannot manage huge peaks. Need to encourage donors to donate over a longer time frame #F2FNHSBT

'Surgical tail' with repeated visits to theatre over weeks/months- also requires increased supply. Rescheduling of cancelled surgery also needs more blood. Increased demand is ongoing for a long time #F2FNHSBT

Use of imported plasma for young patients is topical. Balance of risk is important. Substitute to reduce the impact of delay #F2FNHSBT

Octaplas has recently increased shelf life for thawed component to 5 days for use in unanticipated major haemorrhage, in line with UK FPP #F2FNHSBT
medicines.org.uk/emc/product/41…

Ability to return unused units to NHSBT would be important to help demand in subsequent weeks. Currently not possible though #F2FNHSBT