The effect of the SARS‐CoV‐2 pandemic and civil unrest on massive transfusion protocol activations in Minneapolis 2020

Abstract

Background The year 2020 presented the transfusion community with unprecedented events and challenges, including the ongoing SARS‐CoV‐2 (COVID‐19) pandemic, and more recently by civil unrest, following the death of George Floyd in late May of 2020. As a level 1 trauma center located in Minneapolis, Minnesota, Hennepin Healthcare (HCMC) offers a unique perspective into the changes in massive transfusion protocol (MTP) activations and usage during this tumultuous period. This may provide insight for addressing similar future events. Study design and methods MTP logs from March 2020 to August 2020 were compared to logs from March to August 2019. The data were de‐identified, and MTP activations and component usage were categorized by activation reason. These categories were compared across the 2‐year period to examine the impact of COVID‐19, including stay‐at‐home orders, and civil unrest. Results For the examined 6 months of the year 2020, there were a total of 140 MTP activations, compared to 143 in 2019. There were more activations for violent trauma (VT) in 2020 than 2019 (44 vs. 32). This increase in activations for VT was offset by a decrease in non‐trauma activations (54 vs. 66). There was a significant increase in the number of components used in VT activations. Discussion During 2020, the initial mild decrease in MTP activations was followed by a dramatic increase in the number of activations and component usage for VT in June and July of that year.

Blood shortages and changes to massive transfusion protocols: Survey of hospital practices during the COVID-19 pandemic

“…trauma-related MTP activations, including the patterns and length of community responses and measures taken to mitigate spread of the virus such as lockdowns and "stay-at-home" orders, variations in traffic patterns and accidental traumas, and general societal and geopolitical factors [20,21]. Interestingly, while many hospitals have struggled with blood shortages at different time-points throughout the pandemic, several respondents to our survey have not experienced blood shortages, or are just now beginning to face shortages.…”

The impact of the COVID‐19 outbreak on activation of the massive transfusion protocol in the emergency department

“…Recently, Braun et al reported that the number of MTP activations significantly increased because of violent trauma during the COVID‐19 pandemic in the United States of America [7]. In contrast, in our study population, most traumatic cases with an MTP trigger were due to motor vehicle ( n = 26, 56.5%) and falling ( n = 13, 28.3%) accidents, and no notable difference in traumatic cases with an MTP trigger was observed during the COVID‐19 outbreak.…”

The National Blood Shortage—An Impetus for Change

“…The increase in healthcare utilization combined with increased trauma activity and unprecedented rates of violence across the country depleted the available resources by an estimated 10% to 12% surplus usage. [1][2][3][4][5][6] The American Red Cross (ARC) and America's Blood Centers (ABC) have tried to alert the public to the ongoing need for blood donations. For example, the American Red Cross (ARC) released a statement in June of 2021:…”

“…However, as the nation reopened and healthcare services resumed, a surge in blood consumption ensued. The increase in healthcare utilization combined with increased trauma activity and unprecedented rates of violence across the country depleted the available resources by an estimated 10% to 12% surplus usage 1–6 …”