Texas City Disaster Demonstrated Need for National Coordination

On April 16, 1947, at 9:12 a.m., the French freighter SS Grandcamp exploded while docked at a wharf in Texas City, Tex. Many consider this accident to have contributed indirectly to the formation of the American Association of Blood Banks. In the first paper presented at the Blood Bank Institute meeting 7 months later in November 1947, William C. Levin, MD, and L. Jean Stubbins, MT, outlined the treatment of those who were wounded in the explosion, and the effort to provide blood for them.

Texas City is approximately 10 miles from Galveston, so of the more than 5,000 explosion victims, the 1,784 who needed hospitalization were taken to John Sealy Hospital and the University of Texas Medical School in Galveston. “Within 4 hours of the explosion, 1,888 150-cc units of pooled plasma were administered to disaster victims brought to John Sealy Hospital,” Levin and Stubbs recalled. “Fortunately, we had 87 pints of whole blood in the bank at the time of the explosion.” Another 43 pints of group O blood were drawn from donors that afternoon, before a second freighter also exploded. This supply was adequate until the first shipment of blood from the Buchanan Blood Center [Dallas, Tex.] arrived in Galveston. After that, the John Sealy Hospital depended for the next several days on the blood sent from Dallas.

Early on in the emergency, the William Buchanan Blood Center offered to handle blood procurement —an offer gratefully accepted by the John Sealy Blood Bank. The blood was “prepared by the Baylor Hospital Blood Bank personnel, who grouped, Rh typed and ran serologic tests on it.” The blood was then transported by United States Navy planes to Galveston, with individual pilot tubes on each bottle, packed in refrigerated cases.

Sealy and Buchanan staff “felt obligated to reject many offers of whole blood from other cities because there were no dependable organized institutions that could draw the blood, group and Rh type it.” Without a national organization, blood banks were not consistent in requirements for staff education, procedures for processing blood or proper care of the blood during transport. No easy way existed for them to communicate with each other. Some of the challenges included the following:

• Pilot tubes not attached to the unit.
• Inadequate labeling.
• Improper refrigeration during delivery.
• Failure to send administration sets with the blood unit.
• Lack of ABO grouping, Rh typing and other serologic test results.
• Lack of communication with those in the disaster area to identify and meet rapidly changing needs.

The lessons learned from this experience not only strengthened the cooperation among the blood banks in Texas; it also broadened the realization that, throughout the nation, many blood banks were in operation using a wide variety of procedures. These blood banks had no way of getting together, learning from the more experienced among them or standardizing operations.

Reprinted in part from Growing, Maturing, Changing…. A History of the American Association of Blood Banks. Bethesda, MD: AABB, 1997.