Question about Emergency blood transfusions on board?

[burnsie]

I was reading another thread about an altercation with a passenger getting beaten up. Apparently on the cruise there were several emergencies, one which they had asked for blood donors. One of the posters had commented they would not accept their blood because they did not have their blood donor card on them.

 

Brought several questions to mind. Has anyone had experience receiving blood on board.

 

Is the donated blood tested for the usual host of diseases that it would be tested in the states?

 

I know the medical facilities aboard the newer ships are pretty state of the art but was wondering what kind of Lab facilities they have.

 

After a lady who started from a reaction to what she took for sea sickness ended up being taken off the ship in St. thomas and they where transfusing her to stabilize her before flying her home to the states. Yes, I was freaked at the thought of a transfusion outside the states and now buy travel insurance.

 

Before you flame me I worked 18 years in the lab and saw to many results come through and read to many reports from stuff that was started from care outside the country. As bad as it can be here at times believe me it can be so much worse.

[Riggy84]

Would they even have the time and/or equipment to test the blood before transfusing?

[Agutaya]

I was reading another thread about an altercation with a passenger getting beaten up. Apparently on the cruise there were several emergencies, one which they had asked for blood donors. One of the posters had commented they would not accept their blood because they did not have their blood donor card on them.

 

I doubt the ship would have time or the equipment to test blood before using it and would therefore only use it in a life or death emergency situation. Presumably by only accepting blood from someone with a blood donor card they would at least have been tested the last time they donated. Although not perfect it is probably the best screening they could do in a dire situation. Hopefully someone else can enlighten us further.

[gfd_2]

huh.... I was ready to respond that I couldn't imagine that any cruise line would drop the $$$ needed to build and stock a blood testing lab on each ship that might be used once every couple of years.

 

then I found two articles on RCCL

 

1.) In a report on its medical preparedness, Royal Caribbean said it handled 305 cardiac-related cases fleet wide in 2010, including 15 serious ones, and 10 cases involving blood transfusions that were performed by the ship doctor." from here: http://articles.sun-sentinel.com/2012-01-30/business/fl-cruise-ship-deaths-20120130_1_cruise-ships-cruise-lines-brett-rivkind

 

and this

 

2.) "... Blood transfusion involves the process of transferring lifesaving blood or blood products intravenously into the body of a person in need due to loss of blood. Because of the very nature of blood, the many blood types, and strict storage and testing requirements, cruise ships are not capable of storing blood to support a transfusion program.

As a result, in the past when a patient needed blood, the best alternative was to risk an emergency basket-lift via helicopter (when and where available) and/or to divert the ship to the closest available port. Each of these options involves inherent delays in priority medical care when seconds count.

In 2010, RCL ships received the equipment, training and procedures necessary to conduct transfusions at sea. In the event a patient requires blood, registered blood donor guests onboard are requested to respond to the ship’s medical facility. The advantage of using guests who are registered blood donors is that they know their blood type, have been

regularly screened for blood-related diseases, are familiar with the system, and are accustomed to the process of giving blood. The medical team then commences a screening and monitoring process that leads to a transfusion at sea.

Since the start of this new program, patients have received the benefit of this new lifesaving program and returned home safely. In 2010 we provided transfusions to 11 patients, and in 2011, that number increased to 16 patients. “Being able to transfuse blood has really saved lives on board,” says Dr. Art Diskin, Global Chief Medical Officer for

RCL. “Even if we do eventually evacuate the patient by helicopter or boat, they are more likely to survive if we have started replacing their blood loss with whole blood."

 

from here: http://media.royalcaribbean.com/content/en_US/pdf/stewardship-report.pdf

[Chicky2181]

I'm not a medical professional but I know there are other factors that are important in determining of you can receive another's blood. It's not just about the blood type. I believe it's called cross matching.

[EVALUATOR]

I'm not a medical professional but I know there are other factors that are important in determining of you can receive another's blood. It's not just about the blood type. I believe it's called cross matching.

 

Before Mrs E. passed away she would need 2-3 units of packed red blood cells every 10-21 days. This went on for over 2 years. Getting 0+ was the easy part. Often the medical facilities had to send the blood samples to the blood bank for a match. Matching the blood for A&A was really difficult. Transfusion requirements were the biggest deterrent we had to cruising more often.

 

But in a get blood or die situation Drs. do the best they can.

[burnsie]

Going to ask a friend who is a Lab Director what it would entail. I will let you know what I find out.

 

Stay tuned.

[gfd_2]

"In 2010, RCL ships received the equipment, training and procedures necessary to conduct transfusions at sea. In the event a patient requires blood, registered blood donor guests onboard are requested to respond to the ship’s medical facility. The advantage of using guests who are registered blood donors is that they know their blood type, have been

regularly screened for blood-related diseases, are familiar with the system, and are accustomed to the process of giving blood. The medical team then commences a screening and monitoring process that leads to a transfusion at sea.

Since the start of this new program, patients have received the benefit of this new lifesaving program and returned home safely. In 2010 we provided transfusions to 11 patients, and in 2011, that number increased to 16 patients. “Being able to transfuse blood has really saved lives on board,” says Dr. Art Diskin, Global Chief Medical Officer for

RCL. “Even if we do eventually evacuate the patient by helicopter or boat, they are more likely to survive if we have started replacing their blood loss with whole blood."

[OCruisers]

"In 2010, RCL ships received the equipment, training and procedures necessary to conduct transfusions at sea. In the event a patient requires blood, registered blood donor guests onboard are requested to respond to the ship’s medical facility. The advantage of using guests who are registered blood donors is that they know their blood type, have been

regularly screened for blood-related diseases, are familiar with the system, and are accustomed to the process of giving blood. The medical team then commences a screening and monitoring process that leads to a transfusion at sea.

Since the start of this new program, patients have received the benefit of this new lifesaving program and returned home safely. In 2010 we provided transfusions to 11 patients, and in 2011, that number increased to 16 patients. “Being able to transfuse blood has really saved lives on board,” says Dr. Art Diskin, Global Chief Medical Officer for

RCL. “Even if we do eventually evacuate the patient by helicopter or boat, they are more likely to survive if we have started replacing their blood loss with whole blood."

 

Yes .... Above is totally true. On Oasis there was a call for anyone with a certain blood type (rather rare) and a doner card to please report.

 

~~~~~

[SRQfireman]

"In 2010, RCL ships received the equipment, training and procedures necessary to conduct transfusions at sea. In the event a patient requires blood, registered blood donor guests onboard are requested to respond to the ship’s medical facility. The advantage of using guests who are registered blood donors is that they know their blood type, have been

regularly screened for blood-related diseases, are familiar with the system, and are accustomed to the process of giving blood. The medical team then commences a screening and monitoring process that leads to a transfusion at sea.

Since the start of this new program, patients have received the benefit of this new lifesaving program and returned home safely. In 2010 we provided transfusions to 11 patients, and in 2011, that number increased to 16 patients. “Being able to transfuse blood has really saved lives on board,” says Dr. Art Diskin, Global Chief Medical Officer for

RCL. “Even if we do eventually evacuate the patient by helicopter or boat, they are more likely to survive if we have started replacing their blood loss with whole blood."

 

What is different about this post than the one 3 hrs earlier?? I'm confused why this got posted.

 

Here's a weird question though.....for those of you that donated, did you happen to get "anything" for donating blood? I see advertisements on land where they offer gift certificates and such. I doubt they do, but just curious if by chance ya get anything? Free dessert with dinner? lol :D

I know if it was me donating, I'd just be happy to know I could have saved somebodies life

[Kellie Poodle]

I'm a card carrying blood donor. O+ so I'm the "universal donor".

 

I will make sure I take my card with me on my future cruises. Something I never thought of before, but will do in the future.

 

I suggest that others with donor cards might add taking their cards to their packing lists.

[Chicky2181]

What is different about this post than the one 3 hrs earlier?? I'm confused why this got posted.

 

Here's a weird question though.....for those of you that donated, did you happen to get "anything" for donating blood? I see advertisements on land where they offer gift certificates and such. I doubt they do, but just curious if by chance ya get anything? Free dessert with dinner? lol :D

I know if it was me donating, I'd just be happy to know I could have saved somebodies life

 

I get juice and cookie! That's all I need.

[megs1954]

O- is the universal donor. Not O+. There can still be complications with receiving O- blood. It's better then nothing when needed.

[Chicky2181]

I'm a card carrying blood donor. O+ so I'm the "universal donor".

 

I will make sure I take my card with me on my future cruises. Something I never thought of before, but will do in the future.

 

I suggest that others with donor cards might add taking their cards to their packing lists.

 

That's a great idea. I am definitely doing the same. Hubby and I are both A+, so I like that we could possible get each others blood if needed. To bad my daughter is O+.

[Kellie Poodle]

O- is the universal donor. Not O+. There can still be complications with receiving O- blood. It's better then nothing when needed.

 

Sorry. I had been told O+ was, most probably by someone who was misinformed.

 

I started giving blood in the 70's when I had three very small children and a husband who taught school and worked part-time on evenings and weekends. I found out that someone would watch my children and I could lie down in peace for at least 30 minutes twice a year at the local blood drive. I also got to eat a guilt-free Twinkie.:)

 

Children are adults with their own families but I still do it as I can't think of a better way to show my gratitude for good health.

[alexkrn46]

I have given blood many times, but since I have had cancer I am now excluded I was popular since I am O pos. I have check many times but cancer remains an exclusion.

[LABCHICK]

O- is the universal donor. Not O+. There can still be complications with receiving O- blood. It's better then nothing when needed.

 

You are positivly correct.

[lah66]

When I read about RCI calling for blood donors for one woman who was later airlifted, I thought for sure the author was mistaken...being a Clinical Laboratory Scientist for 25 years, I know what the Blood Centers go through to ensure our blood supply is safe and I know all what we have to do in the lab with blood typing, antibody screening and crossmatching to ensure compatability....There is no way cruiselines could outfit a lab to do all the testing that is done and get the unit to a patient in a timely manner! Thank you gfd2 for posting the article..that really makes a lot of sense..I assumed ships carried a few already tested O Neg Packed cells and a few fresh frozen plasma for such emergencies..It makes sense that the cruiselines would not have to follow US guidelines when it comes to transfusions....very interesting.... I will definitely carry my donor card on cruises from now on!

 

SRQfireman: In the US, blood centers cannot offer any kind of prize or promotion for donating blood (plasma is different) since they need to be assured that you came strictly voluntary...they are afraid people who should not donate will try to just for the incentive....

 

Labchick...are you a Med Tech or a dog lover?Always wondered when I saw your screen name...

[adirondacksailor]

When I read about RCI calling for blood donors for one woman who was later airlifted, I thought for sure the author was mistaken...being a Clinical Laboratory Scientist for 25 years, I know what the Blood Centers go through to ensure our blood supply is safe and I know all what we have to do in the lab with blood typing, antibody screening and crossmatching to ensure compatability....There is no way cruiselines could outfit a lab to do all the testing that is done and get the unit to a patient in a timely manner! Thank you gfd2 for posting the article..that really makes a lot of sense..I assumed ships carried a few already tested O Neg Packed cells and a few fresh frozen plasma for such emergencies..It makes sense that the cruiselines would not have to follow US guidelines when it comes to transfusions....very interesting.... I will definitely carry my donor card on cruises from now on!

 

SRQfireman: In the US, blood centers cannot offer any kind of prize or promotion for donating blood (plasma is different) since they need to be assured that you came strictly voluntary...they are afraid people who should not donate will try to just for the incentive....

 

Labchick...are you a Med Tech or a dog lover?Always wondered when I saw your screen name...

 

Well stated, lah66. I'm a med tech with most of my experience in blood banking and our medical center has a large donor center and bloodmobile, drawing many donors daily, and, due to costs, we even send out donor samples for testing rather than doing it on site. Do you think they at least do a type and antibody screen before transfusing? Hope so...

[adirondacksailor]

lah66,

 

Now that I thought about it a minute or two, they must treat this as strictly an emergency transfusion and just transfuse without an antibody screen. Hope they at least do a quick blood type. That wouldn't be very expensive to keep those vials on hand. I wouldn't want a unit of blood without taking the one minute of testing needed to verify the type on that donor card.

[lah66]

My husband (also a Med Tech) and I were just talking about that and we guessed probably just a blood type is done on the patient and donor...risky, but if your life is in peril, it is worth it. Would not want to have to deal with a transfusion reaction at sea....

We also wondered if they hired Med Techs on the ship...we would do anything to get on a cruise ship more often...but most likely the docs do the lab work...wouldnt that be a great place to work?

[EVALUATOR]

When I read about RCI calling for blood donors for one woman who was later airlifted, I thought for sure the author was mistaken...being a Clinical Laboratory Scientist for 25 years, I know what the Blood Centers go through to ensure our blood supply is safe and I know all what we have to do in the lab with blood typing, antibody screening and crossmatching to ensure compatability....There is no way cruiselines could outfit a lab to do all the testing that is done and get the unit to a patient in a timely manner! Thank you gfd2 for posting the article..that really makes a lot of sense..I assumed ships carried a few already tested O Neg Packed cells and a few fresh frozen plasma for such emergencies..It makes sense that the cruiselines would not have to follow US guidelines when it comes to transfusions....very interesting.... I will definitely carry my donor card on cruises from now on!

 

SRQfireman: In the US, blood centers cannot offer any kind of prize or promotion for donating blood (plasma is different) since they need to be assured that you came strictly voluntary...they are afraid people who should not donate will try to just for the incentive....

 

Labchick...are you a Med Tech or a dog lover?Always wondered when I saw your screen name...

 

What do you call a prize or promotion?

I get free movie tickets, steak dinners, tee shirts, and tote bags every time.

[jonbgd]

Back in the day they didnt test the blood as much as they do now.

 

In my early Corpsman days, one of my good freinds was a Navy Seal, I went Marines he went Seals

Well he got some bad blood and developed AIDS. They lost a good man because they didnt screen for it back than.

This is when the were just indentifying HTLV3 which was changed a couple years later to what we know it today as HIV.

[rosebud1g]

A friend of mine was cruising on Enchantment on an 11 day sailing last yr.

An announcement was made they urgently needed blood for a sick

passenger for a certain blood type. He told me 20 fellow passengers went

down to the Medical Facility and were asked right away who had any alcoholic beverages that day to please raise their hands, if they had any alcohol they were told to please leave. Only 4 passengers were able to donate. My friend was one of them, and the medical team was able to keep the sick passenger stable until they could evacuate her.

[Arizona Cruz Chic]

Before Mrs E. passed away she would need 2-3 units of packed red blood cells every 10-21 days. This went on for over 2 years. Getting 0+ was the easy part. Often the medical facilities had to send the blood samples to the blood bank for a match. Matching the blood for A&A was really difficult. Transfusion requirements were the biggest deterrent we had to cruising more often.

 

But in a get blood or die situation Drs. do the best they can.

 

 

I am very sorry for your loss of Mrs Evaluator.

 

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