Scarcity of RBCs

[donedeal]

How scarce are units of packed red blood cells and fresh frozen plasma? Is the shortage detrimental, meaning it should only be used in serious cases where the outcome would prove worthwhile? Or is there more to go around where it can be used a little frivorously? For example, at the hospital one patient was given 3 units of RBCs and 2 units of fresh frozen plasma. He was born in 1918 and had little cognitive function. Yes, the blood will prolong his life, but perhaps only long enough to spend a few extra days in the ICU. If blood was a product of mass production, such as normal saline, then by all means. But if there really is a great shortage, shouldn't this limited life saving product be reserved for the patient with the greatest need AND the greatest potential outcome? While even more scarce, would you give an organ donation to an 89 year old?

[Ridryder 911]

Wow ! Who made you God? I did not realize blood was in that short of demand since everyone makes it every second of their lives..

I guess I could say that maybe we should start discussing younger people involved in trauma should not be worked upon. Since they are taking up "blood supplies" and as well hold higher non-insurable ratios, causing increasing hospital and medical rates. Same irrational madness...

Yes, there should be considerations on whom receives organ's ... and this should involve criteria for the young as well. The junkie that screwed up their liver and heart with drugs and alcohol, etc... Should they get blood or organs as well?

Again, there are times blood maybe in need of supply. As of yet, I have not heard any alarms and warnings that there is any major shortage. Summer is always the highest month with trauma, etc..

[donedeal]

not trying to play god here, just simply asking:

1.) is there a shortage of blood supply?

2.) if so, does it seem appropriate to ration the supply based on need alone or need and potential outcome?

3.) if based on need and potential outcome, if there is a scarcity, then is it fair for someone in their late 80's to receive 5 units of RBCs/frozen plasma (a large supply for 1 individual)?

[brentoli]

My 91 year old father received 3 units of blood in his last hospital stay.

It prolonged his life one week.

Long enough to have his last thanksgiving dinner with my brother and his family.

Is it worth it?

You save blood by cancelling elective surgeries. Not by keeping it from people that need it.

[Ridryder 911]

Again unfortunately, another posts initiated from someone who does not understand medicine or ethics. Three units of blood (PRBC's or whole?) is not that much. Hell, I have given 3-4 units to many "younger" patients that have a history of G.I. bleeds from alcohol abuse, or have cirrhosis of the liver, HIV, etc.. is this fair to others as well?

It is a dangerous slippery slope, when we start basing treatment upon personal feelings than upon scientific data. Albeit, the scenario did describe poor outcome, so does mine, would you withhold on them as well?

I checked the web site for my area and there is no increased shortage than normal.

R/r 911

[Dustdevil]

Yes, this is a question that is going to be wholly dependant upon where you are and when.

There is no one size fits all answer.

[cosgrojo]

I agree with rid. If you start questioning the scarcity and needs of these things, you are making some very slippery decisions. In a civilized culture, with the relative affluence that we enjoy in this country, withholding blood products based on age and efficacy of outcome raises some pretty scary societal implications.

[Dustdevil]

If you really need them, I have a guy here with RBCs to spare.

His CBC came back with a red count of 48.5 the other day. :shock:

Obviously, the lab farked up and misplaced the decimal point, but it was fun to ponder for a moment.

[AZCEP]

Had he just come down from the mountains?

Was his SpO2 >90%?

I suppose bloodletting has it's place in modern medicine after all.

[brentoli]

Please stop giving my lab results out in public Dust. It hurts my reputation. Really. :violent1: