Handling blood requests at late hours in the night is not new for the Emergency Wing at Sankalp. 19th April 2013 was one such day. We received A- SDP(Single Donor Platelet) request.
The patient was suffering from dengue. When a person is affected by dengue, the platelets count usually decreases from lakhs to thousands. In this case, the count at that hour (at 11:30 PM) was less than 10,000 in the patient. With such a low count, the patient side was informed to arrange two to three A- SDP units.
SDP donation is a type of blood donation wherein only the platelets are extracted from the donor’s blood and the remaining components are transfused back into the donor. This is a longer procedure and generally takes around two hours.
For this particular request, with such a plunge in platelet number and being Friday late night, it made the patient side extremely anxious. As it is, finding negative group units is a challenge. Here the doctor had told the family to immediately organise for 2-3 people who were willing to donate platelets by the apheresis method in the middle of the night. The family faced a very anxious situation.
Usually, the time taken to donate, transfuse and wait for the body to respond to a single SDP unit would take around 8 hours. SDP Units are usually not transfused consecutively. Only if the body begins to respond negatively to the transfusion will another unit be required. Medically speaking, the chances of 2 SDP transfusions overnight was highly unlikely. However, the word of the doctor is the last word for the family.
When the emergency call landed on our phones, we started helping the family by first understanding the situation. Having known the fact that two units of SDP back-to-back was an unlikely situation, we decided to just get one unit donated that night. A big thank you to the SDP Donor! Even for this donation a large number of donors were woken up in the middle of the night and requested to come forward to donate. If it was not for the reassurance from Sankalp and the request to go back to the doctor and confirm if he really meant to use 2 SDP units through the night itself, the family would have panicked for longer and numerous other donors would have been disturbed and put to inconvenience un-necessarily.
On following up with the blood request next day, we heard that the platelet count had increased to considerably good level. We never received a call again for another unit.
This is one of the numerous situations where the doctors convey the requirement of blood to the family in haste without actually explaining the plan and detail. Even though there may be time at hand, every request reaches the family as if it is most immediate. This not just harasses the family, it also goes on to harass the donors! There are those instances too where a doctor who just wants packed red cells or whole blood(if PRBC not available) casually ticks whole blood on the form. With most centres preparing components now, the poor family members keep calling blood bank after blood bank insisting on whole blood units even though massive stocks of PRBC are available.
All that needs to be done is take a little more time to carefully make requests for blood products and give proper context to the nursing staff and patient's family. With this most appropriate and optimal steps can be taken to make arrangements. It leads to best utilization of units on shelf, minimization of emergency donations and avoids wastage.