KAILUA-KONA, Hawaii — Three years ago, a Kona Community Hospital nurse drove overnight to Hilo Medical Center to get platelet units for a friend fighting for his life following a motorcycle crash.
The hospital had run out of its stock, and Anne Broderson was determined to do everything she could to save Elvis Sheppard. Four hours later, she returned with two more units of platelets. But Sheppard ultimately succumbed to his injuries and died several hours later.
Looking back on that night, Broderson said, there are a million “what ifs,” but one thing clear to her was an inadequate system to obtain blood products in an emergency situation.
Broderson, now a nurse practitioner at Alii Health, thinks emergency personnel need to be more forward-thinking when it comes to blood collection and look at ways to improve on the current systems.
“Being that since we’re in such an isolated place, we need to be thinking in a way that makes us more sustainable,” she said. “I really feel like blood drives on the outer islands are an untapped resource.”
The Big Island blood bank needs thousands of units of blood every year.
In the fiscal year of 2017, Hawaii used 46,033 doses of red blood cells and 8,450 doses of platelets. All blood collected on the outer islands is sent to a lab on Oahu where it is separated into three blood products: red blood cells, platelets and plasma. A supply of these products is flown to the neighbor islands almost daily.
Blood Bank Hawaii provides blood products to North Hawaii Hospital, Kona Community Hospital and Hilo Medical Center. The products are ordered on a regular or urgent basis to accommodate planned and unplanned needs.
Department managers at Hilo Medical Center and Kona Community Hospital believe the arrangement with Blood Bank of Hawaii is adequate for their needs. Gayle Sato, Hilo Medical Center lab manager, said if doctors know there are several casualties coming into the hospital they will order additional supply, which takes four to six hours to get to the hospital.
The local hospitals keep 70 units of red blood cells and 30 units of plasma on hand at all times. After Sheppard’s crash, the hospital increased its units of platelets from two to four. Red blood cells have a shelf life of approximately 42 days, platelets up to five days, and plasma is good for up to a year if it’s frozen. Sato said one unit of blood is equivalent to one pint. The human body generally holds nine to 12 pints of blood.
Kim-Anh Nguyen said in an email all neighbor islands have the opportunity to return unused blood products to Honolulu as products approach expiration, adding it’s rare for hospitals to run out of blood and for one single catastrophic trauma or surgical procedure to deplete the state’s supply.
In the handful of times it’s happened in the last five years, Oahu replenished the shortage within a few hours with assistance from the mainland. It could take up to 24 hours to get blood products to the Big Island in those circumstances.
Sandra Ryan, manager of Clinical Labs at Kona Community Hospital, said the stock of blood products is rotated daily.
If a trauma patient is brought in after normal blood delivery times for BBH, doctors will reach out to hospitals on the island for their additional needs. Life Flight can fly over blood products, but Kona doctors haven’t had to utilize that.
“Blood is precious, and we’re always thinking about our inventory,” Ryan said.
For the majority of what the Kona hospital has, Ryan and emergency room manager Joy Bjornberg think it’s adequate for 99% of their needs.
Broderson, however, disagrees with this assessment and is currently working with Sheppard’s fiancee, Jen Davis, toward obtaining a box truck, estimated at $355,000. The truck would include a machine that separates red blood cells and returns remaining components to the donor. Currently, this equipment is flown in and used at all BBH drives on the Big Island. The only machines that do this platelets are on Oahu at BBH buildings.
“As a result, when we come to the Big Island, we can collect double the amount of red cells from donors with the universally received blood type that is especially needed for trauma cases,” Nguyen said.
Broderson and Davis have gained traction in their goal to increase blood donors on island with their third annual Elvis Sheppard Blood Drive. In July, they broke the state record with 299 donors in a single-day event.
Despite the differences in opinion, Broderson thinks they’ve made great strides toward blood donation education on the island.
“It makes me feel hopeful,” Broderson said. “I know this change has come because of Elvis and what happened that night.”
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