How many peple die annually because they can't get a transfusion or blood product?

How often do people die because blood is not availble to save them?

I’m not talking about bleeding out before help arrives after an accident.

I am asking about people who are in right place to get the blood, but the well runs dry, so to speak. Whatever the person needs, it runs out and the patient dies. I hear periodically about the Red Cross making emergency requests when their supplies are low.

Has anyone come across information about this?

I can’t answer your question. I can offer a few observations, though, that may be of interest.

First, there is virtually always some blood available. True, it may not be an exact match, and may even be of a different blood type, but it is available for just the type of scenario that I think you’re describing. For example, when I used to work in a blood bank (over summer vacation), there was a fixed and unbreakable rule - there had to always be two units (pints) of blood type O negative available. As you may know, O negative blood is, in theory, safe to give to anyone regardless of his/her blood type (the term “universal donor” is often applied to people who are O negative). These two pints were there just in case some was truly bleeding to death but no other blood was available or if there simply wasn’t enough time to determine the patient’s blood type.

Beyond that, however, is the hard-to-believe fact that it’s very, very hard to die because of anemia (low red blood cell count). What kills people is the lack of circulating blood volume, i.e. lack of fluid in the vessels, regardless of whether there is, or is not, red blood cells in that fluid. In the absence of sufficient blood volume (i.e. the absence of sufficient blood fluid but having nothing to do with the amount of red cells in that fluid), a person will die because of low blood pressure (shock). Think of it this way - if you have a pipe with not much fluid in it, the pressure in the pipe will be low. Add fluid to the pipe and the pressure within it will go up. Similarly, without a sufficient head of pressure, blood can’t flow into the brain and all the other organs. Death will come much faster this way than from lack of red blood cells (i.e. anemia).

I should also point out that with administration of intravenous fluids to replace or restore blood volume, there is often some effect to mobilize red cells that had not been circulating but were essentially sitting idle, stagnating.

Of course, people can die from acute anemia. Obviously, even if blood volume is maintained, the complete absence of red blood cells, for example, will kill (since without red cells, you can’t deliver sufficient oxygen to your tissues). My point is that such a scenario is awfully rare (despite what the surgeons say!).

I don’t have any statistics, but there have been several cases at my hospital where patients had to wait quite a while to get a blood product that we didn’t have in stock. It’s usually patients with multiple antibodies who need specially-typed blood that’s negative for all those antigens. We put in an urgent special order to the provincial blood bank and they’ll do their best to find units we can use, sometimes taking up to four hours if we need to have units brought in from Quebec city, but that’s definitely the exception.

For the average person, I don’t think there’s too much to worry about. And if you’re one of those people with several antibodies, or antibodies to high-incidence antigens, there’s the option to bank your own blood. They can deep-freeze the cells and keep them in storage for several years until you need them.

Ooh, a kind of expert! So let me ask you a couple of things… Are we talking mostly about trauma victims? And if not, what, elective surgery types?

I would imagine that for the former, you might need a whole slew of blood if someone is literally torn up pretty badly. Can you tell me something about the support strategies they use on the patient while waiting for the rare blood?

FYI, I started a related thread in GD about medical expeiments performed to test a blood substitute product called Polyheme. Maybe what I learn here might change my position over there,

I believe that when blood begins to runs short, hospitals can reschedule elective surgeries. This leaves the remaining reserves available for serious cases who need blood in an emergency or whose surgery or transfusion cannot wait.

(Not sure if you’re aiming at me or KarlGauss, but I’ll give it a shot)

We’re not a trauma hospital, so we don’t usually get the disastrous cases. We get the occasional person come into the ER needing blood immediately, without time to do the testing, and then we give out only O negative units. There’s a special procedure involved - we need the doctor to sign off on the uncrossmatched blood, because even if it’s Oneg there’s still a tiny chance of a reaction. Then we get a specimen from the patient and run back to the lab to start testing, to make sure any subsequent units we give him will be compatible.

Most of the bleeders I see here are in the Intensive Care Unit; people not doing well after major heart surgery, for example. In that case, it’s not just blood that keeps them going. We’ll give out albumin solutions, which are volume expanders, to help keep their blood pressure at a normal level when they’re losing a lot of blood. We give platelets and plasma to help them clot, so eventually they won’t be losing as much blood. It’s as much about replacing the lost blood (and volume, and clotting factors) as it is about stopping the loss in the first place.

Honestly, what seems to run out the fastest isn’t blood - it’s platelets. They’re only good for a few days after being donated, so they’re not something that can be stockpiled. And when patients are oozing lots of blood after surgeries, they tend to need platelets.

*Cranky’s * right, surgeries can always be rescheduled if there’s concern about a shortage. Most people going in for elective surgeries are encouraged to make an autologous donation beforehand so it’s ready for their surgery date.