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The prescribed form about releasing of blood products in urgent situations had not been established in our hospital. In 1986, however, agreement for emergent transfusion was decided in hospital transfusion committee and the manual was made about releasing of blood products in urgent situations. The outline of the manual contents is following. In this manual, the degree of uregent is composed of three classes that is, class A, B, and C respectively according to extent of urgency. Blood products are transported to doctors within ten minute as soon as blood grouping tests and crossmatching test by saline technique are completed in a case of class A. Blood products are issued at twenty minute after finishing crossmatching tests by saline and enzyme (bromelain) techniques in class B or are provided at thirty five minute after completing crossmatching tests by saline, enzyme and antiglobulin techniques in class C.Then, we analyzed the annual state of transfusion according to this manual at the emergency center in Bokuto hospital. As the result of findings, ordered number as class A had about one third of total urgent orders. The cases of multiple trauma due to traffic accidents which were most frequent occupied 43.2% of total cases in class A. Ordered number as class B was under 10%, and as class C was over 60% respectively. In class B, cases of gastrointestinal bleeding which was most frequent had 43.2% of total cases belonging to this class. In class C, although the request of blood products prepared for urgent operation was most frequent, actually transfused cases were about one third of total cases in this class.From investigation in this time, it was noticed that the situation called for uregent transfusion was various but there was no case to that transfusion could not be waited for ten minute at least.

Release of blood in urgent situations. Situation on blood supply in Tokyo Metropolitan Bokuto Hospital.