No abstract

Introduction: Management of massive hemorrhage has been advanced in the last decade and the survival rate of patients who suffered from massive hemorrhage had been improved. Evidence-based recommendations are required to guide the management of such situations, which when implemented may improve patient outcomes.Methods: Data were collected by review for articles, clinical trials and guidelines. Searches were restricted to articles written in English that were published during the period January 1988 through August 2015. The key recommendations in this article were made based on The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Discussion: Over the recent years, massive hemorrhage is been managed by blood components transfusion and surgical or radiological intervention as applicable. With the advanced laboratory assays and point of care tests, surgical and radiological intervention methods and the availability of factor concentrates preparations, the survival of patients with massive hemorrhage has been improved significantly. Conclusion:This article discusses the available evidences and recommendations regarding management of patients with massive hemorrhage.

SARS-COVID (COVID-19) epidemic is a great challenge for blood transfusion practice. Hospitals were overwhelmed with increasing number of admitted patients with severe COVID-19 infections as well as limitation of variable medical and pharmaceutical resources partly due to lockdown. This retrospective study analyzes the transfusion medicine practice and approach of health institution toward the pandemics before and during the pandemic era over the four years period, 2018 through 2021. Data was collected from blood bank records and laboratory information system for the whole blood donors, apheresis platelets donors, numbers and types of prepared blood components, details of blood components storage and expiry, and blood components for the study period. The data analyzed showed that the total number of whole blood donors dropped during 2020. However, there is a steady increase in number of voluntary non-numerated whole blood donors. The production of packed Red Blood Cells units, Fresh Frozen Plasma units, and Cryoprecipitate units were actually more or less similar or slightly higher in 2020 compared to 2019 and 2018. However, the production of Platelets components showed a drop during 2020. The transfusion for patients at the institution has slightly increased for 2020 compared to 2019. Therefore, the need to procure blood components from other facilities was increased in 2020 compared to pre COVID-19 pandemics. The percentage of expired and wasted blood components units steadily decreasing over the past few years. The data of expired and or wasted collected blood components were compared through the study period and it illustrates that the percentage of expired and wasted units was steadily dropped over the years. This to mention that automated blood transfusion system was implemented late 2019 and put in full effect in 2020. The presence of validated and secured electronic system supports blood bank to eliminate the number of expired and wasted units due to proper inventory management. Along with all the hard work to maintain adequate and safe blood supply to increasing requests of blood transfusion, blood bank at KAMC participated in the national multidisciplinary study of Convalescent Plasma use for critically ill COVID-19 patients.