ABSTRACT
【Objective】 To investigate the availability and convenience of
emergency blood transfusion in
mainland China, and develop
strategies for improvement. 【
Methods】 The
electronic questionnaire was
self-made by the
research team, and pushed to
physicians and technicians related to
emergency blood use and
supply nationwide through the WeChat group of
professional organizations such as the
Chinese Medical Doctor
Association′s
Emergency Resuscitation and
Disaster Medicine Professional Committee. The data was automatically aggregated by the
internet survey platform named
questionnaire star, and analyzed by
statistics software SPSS 21.0. 【Results】 1) General information A total of 3 151
questionnaires were collected, of which 85% (2 678 / 3 151), from 31 provinces, municipalities or autonomous regions in
mainland China were valid, and 39%(1 044/2 678), 22%(577/2 678), 39%(1 057/2 678) were from the east, middle and west region, respectively; 78%(2 099/2 678) were from
tertiary hospitals, and 22%(579/2 678)
secondary hospitals and below; 60%(1 607/2 678), 16%(425/2 678), and 24%(646/2 678) were from
Emergency Department(EM),
Intensive Care Department (ICU) and other departments respectively. The
respondents with senior position titles took up 34%(906/2 678) while those with intermediate and junior position titles took up 30% (798/2 678) and 36%(974/2 678) respectively. 2)
Availability:
63%(1 680/2 678) of the
respondents experienced untimely and insufficient
blood supply at least once during June 2017 to May 2020, of which 75% (1 256/1 680) occurred in the past year. In the past half year, 51% (381/1 057) of
respondents in the western region and 34% (713/2 099) in
tertiary hospitals experienced more
emergency blood shortages (P<0.05). The most prone to clinical
blood supply shortage were
red blood cells and whole
blood,
platelets and other
plasma components,
accounting for 43% (1151/2678), 42% (1125/2678) and 15% (402/2678), respectively. 48% (1 274/2 678)
respondents believed that the insufficient
blood supply for
emergency use " has caused a significant adverse effect on the quality of rescue", and 40% (1 081/2 678) believed that it was " a potential medical
safety threat" .3)Convenience The waiting
time for
emergency blood transfusionwithin 0.5 h, 1 h and 2 h accounted for 28% (741/2 678), 71%(1 903/2 678) and 90% (2 547/2 678), respectively. The waiting
time of
emergency blood transfusion within 0.5 h accounted for 50% (286 / 577) in central region, which was significantly higher than that in eastern or western region (P < 0.05). 67% (889/2 678) of
respondents experienced
blood inventory depletion, of which 30%(792/2 678) had to wait for more than 8 hours for resuming
blood supply. 80% (751/1 057) of the
respondents in the western region experienced
inventory depletion, significantly higher than that in the central region (P<0.05). 4)The influencing factors were mainly insufficient
blood donation,
growth of clinical demand in
blood,
blood waste due to expiration and clinical irrational use, accounted for 56% (1 485/2 678), 23% (619/2 678), 7% (183/2 678) and 6% (167/2 678) respectively. 60% (633/1 057) of the
respondents in the western region considered insufficient
blood donation as the influencing factors, statistically higher than that in the eastern and central regions (P<0.05).5)
Suggestions for improvement included more voluntary
blood donation, development of
blood substitutes,
standardization of clinical
blood use and extension of
blood storage
shelf life, accounted for 49% (1 326/2 678), 24% (645/2 678), 19% (499/2 678), and 8% (208/2 678), respectively. 53% (561/1 057) of the
respondents in the western region suggested strengthening voluntary
blood donation (P<0.05), while 26% (268/1 044), 26% (152/577), 25% (553/2099) of
respondents in the eastern, central region and
tertiary hospitals respectively suggested strengthening the
research and development of
blood substitutes (P<0.05). 56% (504/906) of
respondents with senior professional titles recommended strengthening voluntary
blood donation, while 26% (453/1 772) and 0.9% (164/1 772) of those with intermediate and junior technical titles recommended
research and development of
blood substitutes and improvement of
blood storage
technology, respectively(P<0.05). 【Conclusion】 The whole
blood reserve can not fully meet clinical
emergency needs at present stage, especially in the western region and some
tertiary hospitals,, showing the necessity to adopt comprehensive
measures to further improve the availability and convenience of
emergency blood transfusion, including strengthening voluntary
blood donation, developing
blood substitutes, prompting rational clinical
blood use and improving
blood storage
technology.