AABB24: Preparing the Blood Bank for Mass Casualty Events

We can’t prevent mass casualty events (MCEs), but we can be ready to respond when they happen. 

At a Monday morning session during the 2024 Annual Meeting, speakers highlighted the vital role of blood banks in MCE preparedness, offering insights into inventory management and emergency response protocols to save lives during crises. 

Ricardo Sumugod, MS, MLS(ASCP)SBB, director of clinical laboratories at Northwestern University, kicked off the session with a review of a 2020 meta-analysis of 32 MCEs from 1980 to 2020. In the review, Glenn Ramsey, MD, recommended that blood centers plan for three RBC units, one plasma unit and 0.25 platelet-dose units per admission during an MCE (event-wide). For trauma centers, he recommended 6 RBC units, 4 plasma units and .5 units of platelets. 

Sumugod also emphasized the importance of inventory management and emergency preparedness. Using Northwestern’s system as an example, he demonstrated how hospitals can monitor blood product levels, triggering alerts when inventory drops below critical thresholds. He also recommended robust emergency plans, like the Hospital Incident Command System (HICS), to triage patients and prioritize care during chaotic events. 

Next, Crystal Theiler, MLS(ASCP)SBB CM, transfusion service regional coordinator at Aurora Medical Center/Advocate Health, focused on navigating the logistical challenges of managing blood products during MCEs. 

She outlined her institution’s processes for tracking blood products to ensure traceability from collection to administration, as required by federal regulations. For instance, blood banks prepare coolers with O-positive, O-negative and group A plasma, which are color-coded and paired with tracking forms to expedite documentation while meeting traceability regulations. 

Theiler also highlighted the role of drills in preparedness. Blood banks within her hospital system conduct at least two mass casualty simulations per year. Including tabletop drills and live drills complete with mock blood components. The hospital also participates in community-wide drills involving local emergency response agencies. These realistic exercises help identify areas for improvement and foster collaboration among the hospital and community partners. 

Theiler concluded by underscoring the value of continuous training and preparation, sharing that the blood bank’s protocols, systems and drills have proven effective in real emergency situations.