Blood transfusion essential component of emergency care

RAWALPINDI: The transfusion of blood and blood products is an essential component of emergency healthcare and it helps save millions of lives every year.

The lives and health of millions of people are affected by emergencies every year as according to estimates, disasters have caused more than one million deaths in last one decade with more than 250 million people being affected by emergencies every year. Natural disasters such as earthquakes, floods and storms along with man-made disasters such as road accidents and armed conflicts generate substantial health care demands and the need for front-line treatment.

Apart from emergencies, blood transfusion helps improve life expectancy and the quality of life of patients suffering from life-threatening conditions, such as thalassemia, haemophilia, anaemia, cancer, kidney failure, dialysis, bleeding after child birth, cardiac bypass surgery and supports complex medical and surgical procedures.

Every year on June 14, countries around the world celebrate World Blood Donor Day. The event serves to raise awareness about the need for safe blood and blood products and to thank blood donors for their life-saving gifts of blood.

This year campaign will focus on blood donation in emergencies. In crisis or emergency situation, the natural human response is “What can I do? How can I help?” Therefore, the slogan for the year 2017 campaign is: What can you do? , with the secondary message: Give blood. Give now. Give often.

Over 90 per cent of total blood transfused in Pakistan is donated by friends and relatives of patients while around 10-20 per cent of blood supply is still donated by professional donors.Head of Community Medicine at CMH Lahore Medical College Professor Dr Muhammad Ashraf Chaudhry expressed this while talking to ‘The News’ in connection with World Blood Donor Day.

He said Pakistan’s annual blood transfusion requirement is approximately 1.5 million bags, and 40 per cent of the demand is being met by the public sector. Blood transfusion services in Pakistan are mostly hospital- based. There are nearly 150 public and 450 private blood banks in the country and most of these are unregistered and unregulated due to which business of substandard and unscreened blood has assumed an alarming proportion, he said.

He added that proper blood storage and transportation facilities are not available in many of the country’s public and private sector hospitals, leading to the wastage of a significant proportion of the collected blood.

In Pakistan, most blood banks in the public sector screen blood for HIV and hepatitis B and C as a standard policy while World Health Organization recommends inclusion of syphilis and malaria too in the basic blood screening criteria, said Dr. Ashraf.

Pakistan has a high burden of thalassaemia. According to estimates, as many as 5000 children are born with thalassaemia each year and 70000 patients are registered with the disease. Most services for these patients are provided by private blood transfusion services or by nongovernmental organizations, he said.

He added that factors responsible for low blood collection include lack of education and awareness about the need of safe blood in the community and importance of voluntary unpaid blood transfusion (VUBD) and high prevalence of Hepatitis B, C, HIV/AIDS and anaemia and lack of blood donor requirement and retention strategy.

Providing safe and adequate blood should be integral part of every country’s health care policy and infrastructure, he said.Dr. Ashraf said that all donated blood should be screened for HIV, hepatitis B and C, and syphilis and malaria prior to transfusion.

He suggested that media should be used to raise awareness about voluntary blood donation. Misconceptions about blood donation should be removed.

There is no truth in this assumption that blood donation results in weakness of the body. Any person between the ages of 17 and 65 years and weighing 50kg or more can donate blood at least three times a year, he explained.

He added a donor should not be suffering from some serious disease like hepatitis B, C and HIV/AIDS and he should not be addict.

He said there are a hundred of excuses not to donate blood, but thousand reasons to do so. Being an adult is not only about enjoying your rights but also about fulfilling your moral duties. Half an hour of your time can save three lives, he said.

He explained that after donating blood, you replace the fluid in hours and the red blood cells within four weeks. It takes eight weeks to restore the iron lost after donating blood. There are 10 units of blood in the body of average adult. For a whole blood donation, one pint is collected. You should drink plenty of fluids during the first few hours following the donation, said Dr. Ashraf.

He said blood donations have short shelf-life, so regular donors are essential to secure a constant supply. Blood is the most precious gift that anyone can give to another person – the gift of life, he said. He defines regular blood donors as the individuals donating blood at least twice a year, on a regular basis. Regular, voluntary, unpaid blood donors are also the safest group of donors as the prevalence of blood borne infections is lowest among these donors, he said.

To a query, Dr. Ashraf said giving blood regularly may itself be good for one. It has been ascribed potential health benefit in coronary artery disease. It also gives personal satisfaction. Donors who give blood voluntarily and for altruistic reasons have the lowest prevalence of HIV, hepatitis viruses and other blood borne infections, he said.

However, unnecessary blood transfusions should be avoided, said Dr. Ashraf. Unnecessary transfusions and unsafe transfusion practices expose patients to the risk of serious adverse transfusion reactions and transfusion-transmissible infections including HIV, hepatitis B, hepatitis C and syphilis. Unnecessary transfusions also reduce the availability of blood products for patients who are in need, he said. He suggested that hospital transfusion committee should be established in every hospital in order to decide the requirement for blood transfusion.

According to one estimate, 75 per cent of hospitals in Pakistan do not have transfusion committees, due to which rate of unnecessary and unscreened blood transfusion is very high in the country, which is resulting in high incidence of viral hepatitis and HIV infections, said Dr. Ashraf.