NHSBT issues amber blood alert

Guidance shared from NHS BT to our members 

NHS Blood and Transplant’s red cell stock levels are low, and these levels have reached the threshold at which an amber alert has been issued. NHSBT will remove the alert once they are confident that stocks have reached a sustainable level but expect the alert will continue for at least four weeks.

NHSBT is asking hospitals to:

• Use the EBMA checklist
• Implement their Emergency Blood Management Arrangements for an Amber shortage status and continue to consider transfusion for only those patients in categories one and two of the NBTC red cell shortage plan.
• Use alternatives to transfusion where appropriate.
       o Treat haematinic deficiencies with the appropriate supplement (iron, B12 or folate), unless the patient has haemodynamic compromise.
       o Treat patients who are expected to lose more than 500mls of blood during surgery with tranexamic acid, which reduces blood loss by 25%.
       o Use intra-operative cell salvage with tranexamic acid for patients who are expected to lose a very high volume of blood (for example in cardiac and complex vascular surgery, major obstetric procedures, and pelvic reconstruction and scoliosis surgery).
• Use a restrictive red cell transfusion threshold, haemoglobin of 70 g/L unless patient is bleeding, has acute coronary syndrome, or is on a chronic transfusion programme.
• Don’t proceed with elective surgery in patients with anaemia until it has been properly diagnosed and treated.
• Postpone elective surgery which is likely to require donor blood support (FSSA surgical prioritisation category P4 procedures that are likely to require blood components).
• Ensure early pre-assessment of patients in categories P1-3, check haematinic status and treat deficiencies with appropriate supplement.
• Ensure arrangements are in place to respond to any potential future red status alert.