Gift of a Lifetime

Volunteer blood donors are the only source of life-sustaining supply

He started donating blood as an undergrad at Erskine College. It was easy for students — the bloodmobile parked right on the quad — and everyone figured it was a good thing to do. Today, as a trauma surgeon at Prisma Health in the Upstate, Dr. Benjamin Manning knows for certain that being a blood donor isn’t just good. It’s critically necessary.

“We go through a lot of blood in trauma care,” Dr. Manning says. “A steady, dependable supply of blood is vital — and donors are our only source.”

The Blood Connection must collect 800 donated pints per day to meet the needs of patients across its service area in South Carolina and parts of North Carolina and Georgia.

Summers are never a picnic in the world of emergency medicine — as temperatures rise, so do accidents and injuries. A growing population means these seasonal increases are rising exponentially; trauma admissions at Prisma Health are up 10% overall compared to this time last year, with a 16% increase in the number of patients presenting with potentially life-threatening injuries.

‘There’s no alternative’

Exacerbating the expected uptick during “trauma season” is an unexpected factor: blood donations are at historically low levels.

“We are using more but right now, people are donating less,” Dr. Manning says. He’s been at Prisma since 2006 and while he’s seen short-term shortages before, “this is more pronounced. It’s not just a drop over a busy holiday weekend — it’s become a constant concern.”

People are sometimes surprised to learn how much blood loss can occur from, say, a broken femur or other common injuries, but it’s the all-too-frequent motor vehicle crashes that put the highest demand on the ED’s blood supply. Emergency transfusions sustain life while medical personnel work to stem the source — or sources — of bleeding.

Local statistics are inline with a devastating national trend of low donations: in June, demand exceeded blood collections on 27% of days, according to The Blood Connection. A month before, the numbers were even worse, with shortfalls on 48% of days.

Greenville hospitals are using evidence-based guidelines to reduce the need for blood transfusions via medication and alternative therapies. Some elective surgeries can be postponed, but hospitals can’t control the number of traumas or the need for surgeries that aren’t elective, says Amanda Locotosh, Blood Bank Supervisor at Bon Secours St. Francis Health System. “There’s no alternative for someone who is actively bleeding,” she says.

And for oncology patients in need of platelets and red blood cells for supportive therapy or for people suffering from sickle cell disease who require regular transfusions, there’s also no alternative.

Donors are the only source

“We can’t create blood in a lab or replace it with something else,” Locotosh notes. “This isn’t a product that can be simulated — the only way to get blood is via blood donors.”

The nationwide blood shortage is of special concern to the team at Greenville Shriners Hospital. Summer is a busy time at the pediatric orthopedic hospital, which averages three spine surgeries per week when school is out to correct adolescent idiopathic scoliosis. These procedures are extremely time-sensitive because the longer a child waits to have surgery, the more the curvature of their spine progresses.

The surgery can be life-changing but requires the utmost caution. “We have to know there’s available blood [in case a problem arises],” says Mary Peterson, director of Surgical Services. “It’s too much of a risk to perform this surgery without blood on hand.”

Approximately 20% of patients undergoing spinal surgery require transfusions of blood and/or a component of blood product. “Without those units, we would have negative outcomes,” Peterson explains.

Sandy Ellison has worked as a medical lab technician at Greenville Shriners since 1994, motivated by the mission to improve the lives of children. “Without Shriners, a lot of these kids would have nowhere to go,” she explains. “We treat all patients, whether they have the ability to pay or not.”

The pervasiveness of today’s blood supply crisis creates a concern that’s never before been raised during Ellison’s long tenure: the potential delays to children’s time-sensitive surgeries.

“We would never want to turn a child away because of lack of blood,” she says. “That would be a truly sad day.”