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

Abstract

Background and Objectives: An outbreak of coronavirus disease 2019 occurred in mid-May of 2021 in Taiwan. After 2 months of hard work, transmissions were successfully prevented and the number of newly confirmed COVID-19 cases fell remarkably. We evaluated the impact of this outbreak on the massive transfusion protocol (MTP) in the emergency department (ED) of a trauma centre. Materials and Methods:We retrospectively compared the activation and efficacy of MTP before, during and after the outbreak by analysing the clinical data relevant to MTP activations.Results: There was no remarkable change in the average number of MTP triggers per month during the outbreak. The interval from an MTP trigger to the first unit of blood transfused at bedside was significantly increased during the outbreak compared to that before the outbreak (22.4 min vs. 13.9 min, p < 0.001); while the 24-h survival rate decreased (57.1% vs. 71.1%, p = 0.938).There were no remarkable changes in blood unit return or wastage during the outbreak. Conclusion:The COVID-19 outbreak limitedly affected MTP activation and waste of blood products, but significantly increased the interval from an MTP trigger to the first unit of blood transfused at bedside.

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“…The outbreak of coronavirus disease-19 (COVID-19) occurred in May 2021 in Taiwan, [21] profoundly affecting the efficacy of healthcare system and changing the healthproviding practice. [22][23][24][25] Fortunately, the outbreak was controlled with a series of prompt responses and interventions. During the COVID-19 pandemic, the healthcare system was overwhelmed with strained medical resources by a great many patients who required intensive care; and laboratory staff experienced exhaustion with a huge number of specimens for nucleic acid amplification and rapid antigen tests against severe acute respiratory syndrome coronavirus 2.…”

The effects of the COVID‐19 pandemic blood shortage on trauma patients

“…In Taiwan, which did not see the same increase in violent crime as the United States, there were no significant differences in frequency of massive transfusion protocol (MTP) triggers 21 . Although the same metric has not been studied directly in the United States, the relative increase in penetrating trauma did increase the percentage of trauma patients requiring transfusion 14 .…”

Reply to Jacobs et al.: Massive transfusion protocols during the COVID‐19 pandemic

“…We thank Jacobs and colleagues for their comments on our article ‘The impact of the COVID‐19 outbreak on activation of the massive transfusion protocol in the emergency department’ [ 1 ]. Jacobs and colleagues found that half of the 50 surveyed institutions had no change of monthly massive transfusion protocol (MTP) activation in the previous study [ 2 ], which was similar to our results.…”