Health

Red Cross, Hospitals Confront Challenge of Nationwide Blood Shortage

One week after the American Red Cross declared its second ever blood supply crisis, donations are increasing. But the agency still needs more donors to roll up their sleeves before the crisis can end. 

The crisis declaration came as type O positive blood, which is typically used in trauma care, dropped below a one-day supply nationwide. And while hospitals have so far not reported major disruptions to services, more frequent supply shortages show the need for contingency plans.  

“Increased need, and a decrease of folks donating, are sort of a perfect storm,” said Kellie O’Connell, the CEO of American Red Cross of Illinois.

“We’re trying to run as fast as we can to make sure we keep up with the demand,” O’Connell said. 

Blood donations typically drop in the summer, as vacations and school breaks disrupt the regular flow of blood drives. At the same time, demand typically rises alongside traumatic injuries. 

This summer, extreme heat, poor air quality and natural disasters are likely contributors to the decrease in donations. 

All blood supplies dropped by 25% this June, causing the Red Cross to declare an “emergency shortage” in mid-July. The “crisis” declaration came just two weeks later. 

Beyond trauma care, hospitals use blood for surgery, as well as treating premature babies, anemia and chronic illnesses. And before this summer, declining blood supply was part of a longer trend.

“Over the past few decades, the number of donors has decreased,” said Dr. Constantine Kanakis, the incoming medical director of blood bank transfusion services at Northwestern Memorial Hospital.

If the trend continues, hospitals are more and more likely to be confronted with tough ethical dilemmas.

Life-saving blood transfusions typically need to happen fast. And when resources are limited, like during a blood supply crisis, a spike in blood demand can leave providers with little time to make critical choices.

Having a plan in place is an important part of hospital operations, according to Kanakis.

“At the crux is who gets blood first, if everybody needs blood and there’s not enough,” Kanakis said. 

When employing patient-blood management techniques, “we try to use the fewest amount of blood products to achieve the greatest outcome, all while trying to maintain success and safety outcomes,” Kanakis said.

In 2023, Kanakis led a crisis simulation exercise at Northwestern Memorial Hospital that brought together ethics specialists and medical professionals from the blood bank, emergency room, surgery and more.

Using tabletop simulations of real-world scenarios, Kanakis and his colleagues were able to test how hospital protocols might hold up. A survey of participants found the exercise increased confidence that hospital leaders and care providers could respond appropriately to these scenarios. 

Following up on the positive response, Kanakis and colleagues surveyed hospitals around the Chicago area to assess their needs, resources and confidence levels. 

That confidence was higher when there was a plan in place for dealing with blood shortages. But according to Kanakis, having a plan shouldn’t be the finish line. 

“Having a plan or a policy is useless unless you actually practice it,” Kanakis said.

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