Blood Donation: Do They Run Out

Factual Questions
21

I will admit it’s been quite a while since my blood bank days, and I will allow that practices vary from place to place, but unless things have changed drastically since I did training as a clinical pathology resident, which included too much time (for my liking) in transfusion medicine edification, whole blood transfusions are not the norm. At the very least, it is not optimal.

The reasons are several, but the main one is that patients usually do not need all blood components to address their immediate problem, and so it’s much more beneficial and efficient to deliver only the part(s) they do need. My leading caveat again notwithstanding, most whole blood nowadays is separated into packed RBCs and plasma (which even in their now reduced volumes relative to whole blood are indeed quite useful), and the platelets are separated off and pooled from several units. The plasma can then be further separated into cryoprecipitate, in which certain clotting factors are conentrated.

Individual hospitals may order whole blood from a blood bank, and that may have been what you transported as a driver, but the receiving hospital blood banks may have then further processed those whole blood units into components.

It is also possible that they may have transfused the units whole, as whole blood is still used in some circumstances. But, as said, unless things have changed a lot, or unless the institution that trained me was off in its own world, transfusion of whole blood is the exception, not the rule.

22

Should have created a new thread.

23

So the logic is…? Since there are enough donors to “save” all the lives that need saving - or rather since there were enough donors to save all the lives that needed saving up to now - no one else needs to donate? Or individuals don’t need to donate because there will always be other individuals who will donate enough to save all the lives that will need saving? That logic seems so obviously self-contradictory that I have to doubt it is what you are really saying, but it kinda sounds like it.

Perhaps your objection is merely to invoking the notion (propagandistically) that YOUR donation, or any one person’s for that matter, was the ONE that “saved a life”. If so, then that objection can be raised against any net accomplishment of collective activity. As a collective activity to the core, as far as medical care goes, only vanishingly rarely (or on TV) does any ONE person ever “save a life.”

24

Yup, that’s also the case in the USA, I mean, obviously vCJD is a non-story, it was a ridiculous piece of hysteria. But then, even in the UK we’re reluctant to let gay men donate, and that’s also a ridiculous piece of hysteria.

25

As for running out, sure, it can happen. Just two nights ago when I was in the ICU we had to initiate massive transfusion protocol for a patient who was hemorrhaging from somewhere in his upper GI tract. We went through >10 units of blood in ~4 hours, and used up the last of the platelets available. Were they able to get more fairly quickly? Most likely, and since this was at about 2am there weren’t any elective surgeries or other planned needs for blood, but it could have just as easily have happened at 8am.

26

I believe they suggest that if you donate, up to 3 people may live who wouldn’t have otherwise. If the answer to my GQ is ‘No, they do not ever reallly run out,’ then this suggestion is categorically false.

It does not follow from that that one should not donate, and I am not claiming that. You may also read parse their statement literally, and observe that they aren’t actually making the claim I am accusing them of. This is true, but it strikes me as the kind of statement that’s meant to make you think something without actually saying it.

27

So if 10 people needed blood or they would have died, and after tallying up the donations, it turns out that 11 people have actually donated, you would say that for any one of them, if they hadn’t donated, it wouldn’t have led to any of those 10 people dying, therefore you can’t (shouldn’t?) make the claim that each of their donations “may have saved a life”?

I’m just trying to follow your logic…

28

Yes, the question is if the statement would imply, "Because I donated blood last month rather than skipping the donation, there are three people walking around that would have otherwise bled to death in the hospital with doctors running around screaming, “Why is there no blood? Nooooooo!”

29

Considering the qualifying words they put in there (“can” and “up to”), I think quibbling about whether or not a single donor ever saved lives is kind of unnecessarily picky.

30

No, that seems like a reasonable claim. What if they needed 10 life-saving pints a months, and consistently got 100 million pints? And the other 99,999,990 pints were sold at great profit to the vampire community. Would it be reasonable to launch an advertising campaign to increase donations with the claim that it might save a life?

31

Considering what the vampire community does when they don’t get donated blood? Yeah.

32

:smack:

33

Yes, robert_columbia, most blood banks will allow people to ‘bank’ credit for donating. If you donate, you’ll be asked if you are donating into an individual/family bank or into the general bank. If you receive blood from your credit pool you’ll only pay the processing charge. Sometimes people have conditions that require multiple transfusions and they rally the troops, getting friends, cousins, co-workers, etc. to donate into their bank.

This is not to be confused with the practice of having your own, actual blood taken before elective surgery, to be used if you need it. That will be done at the hospital, not through a blood bank.

Meh. I don’t really care if my pint was life-saving, or if it was used for a face lift, or if it just sat around as a contingency against an emergency that never happened and had to be sold to wherever. Extra blood is needed in order for the process to work, and I want the process to work.

Donations fall off if the banks don’t advertise and don’t call donors to remind them. Getting calls is annoying, but they work. And advertising that plays up being a hero works, too. It keeps the process going. They’re not lying. Every donation helps the process and the process saves lives.

If you’re designing a bridge, you calculate the stresses you expect and then multiply them by a safety factor. If you’re budgeting for a kitchen renovation, you add a contingency to your budget because you don’t want a discovered increase to leave you with a half-built kitchen. But advertising that the local blood bank’s contingency volume is getting too low isn’t going to pull in donors even though one good freeway pileup could suck that volume dry. People just don’t work that way. Contingencies are somebody else’s problem.

So I’m not at all annoyed by advertising that may be interpreted by some as a claim that every pint from every donor saves a life. Hey, if it’s all fungible, then every pint did save a life. Or part of it did.

I have no idea what happens on the hospital end of the transfer. What was delivered most was whole blood. A few runs each night would include plasma and I could go weeks without delivering platelets. Although if hospitals could split out plasma and platelets on their own, and that was cheaper, that would also result in the same delivery spread. So I’m perfectly willing to take your word for it.

I also have no idea what the day deliveries looked like, as I was working at night.

34

I agree with most of what you’ve said here, and I don’t really want to quibble too much with the parts I don’t. My question wasn’t whether or not you should give blood; it’s whether or not the common understanding that I think the Red Cross encourages is true. It’s not. They’re spreading misinformation without technically lying. It may very well be justified in order to keep a blood supply on-hand. I have no problem with that conclusion.

35

Seems like we are slipping into a discussion of logic, which is somewhat appropriate, since formal logic (at least as I understand it from a distance) and transfusion medicine both share an overwhelming obsession with nitpicky minutiae. Nonetheless, it is your thread, so here goes: I don’t think you can say that the suggestion that, for example, three people “may” live because of your blood donation (and you are saying that this is the suggestion you object to, correct?) is “categorically” false. Simply including the condition “may” makes the statement a conditional one, not a categorical one. More importantly, look at it this way: The only reason the blood supply would not run dry is because people donate, and at least some of that blood is used to “save lives”. In order for a statement to be “categorically” false (and, again, I concede that I may be wrong from a formal logic point of view, but this is my understanding), is that it has to be false in every instance. The fact that some of the donated blood saved lives – even if not all of it did, or even if had one donation not been made the lives would have been saved anyway – again makes the suggestion that any particular donation saves lives a conditional one, not a categorical one. On the condition that a particular donation was used, it saved a life. Your own example of the 10 B+ donations says the same thing.
Your original question is an interesting one: Has anybody died (recently) due to lack of donated blood? I don’t know. When I was briefly working in blood banking, it seemed we were always able to meet the demand. But to do so often required considerable effort and resources, hunting down available products and wheeling and dealing with neighboring hospitals and blood banks. A lot of white knuckles, but, ultimately, I guess you could say we never “ran out”. I will say that, based on my experience in operating rooms, use of an overwhelming amount of blood products did seem to be a factor in decisions about whether or not to continue “life saving” efforts. At those times, it was not the use of the products per se, but rather the need for their use, combined with the knowledge that they are a finite resource, that was an index of how bad the situation was. If, however, the supply of blood products was virtually inexhaustible (analogous to, say, the use of water or electricity), might some of those efforts have continued longer, and might some of them have been successful? Who knows.

36

I wouldn’t ask this on a normal board, but this is the Dope, so here goes. Would you consider it untruthful advertising if every single unit of donated blood went to someone who needed it, due to surgery or injury, but who would have had a 75% or better chance of recovering even if the blood was unavailable? That is, the blood only sped healing, increased comfort, and decreased their chance of dying of complications while recovering, it didn’t unequivocally save their lives.

37

Again, you’re parsing what they say literally. I’m not. I’m saying their suggestion is categorically false; you’re saying their literal statement can be parsed as true.

But if their statement had been, “if you don’t donate, someone will die,” and the answer to my OP were “no, they never run out”, then their statement would be categorically false - would you agree?

Interesting. Thanks for the data point.

38

Assuming you’re specifically asking me, no. I would not say that that were untruthful advertising. But raise 75% to 100%, and I’ll change my answer.

39

I bet it has. When my micropreemie needed blood, it was given in a 60mL syringe, through a pump that put it into her over 6 hours. Not a lot of blood, but enough that compared to her size, it had to go in verrrrry slowly so her heart could handle it. If a donation is roughly a pint (it is), then nearly 8 60mL syringes could have come from that one donation.

THANK YOU!

40

When I’ve donated, I don’t recall testing for this virus to have ever been a thing. Is this normal practice? Something you have to request/sign up for? Do I have some horrible virus dangerous to preemies? Is it from cats?