A colleague in British Columbia wonders if there are any regulations, guidelines, or policies to set up and maintain a "walking blood donor" program in remote geographic areas, so that in a dire emergency blood can be collected from a known healthy individual and used within minutes of collection without routine testing? The need to bleed and release untested blood in an urgent situation may be a reality faced in some remote communities.

ADDENDA Nov. 17, 2003

The following responses have been received.

1. Editor's NOTE: The information from the University of Manitoba might be germane to this question. (LINK LOST - Sept 27, 2004)

ADDENDA Nov. 18, 2003

2. A Project Coordinator for the Transfusion Ontario Program reports that CAN/CSA-Z902 'A National Standard for Canada - Blood and Blood Components, Section 15' identifies the requirements for developing and maintaining Walking donor programs (15.1-15.6). According to the reporting colleague, this Standard (now in draft form) is expected to be published in April/04.

ADDENDA Nov. 26, 2003

3. A laboratory supervisor at a Canadian hospital in the Northwest Territories reports that until this last year their site in Northern Canada maintained a walking donor program. According to the Canadian colleague, her hospital has dispensed with the program for several reasons:

1. Donor turnout for quarterly screens was down to an all time low.
2. There were too many risk factors to track in terms of a donor's health questionnaire and testing, etc.
3. New draft regulations are stringent. There is usually not enough staff in a remote location to take on the added responsibility of maintaining a current and safe blood donor list.
4. The need for more blood than what can be supplied through on-site stock is very infrequent.

The responding colleague reports that some 'work around' solutions have been explored which may be useful. One approach is to create solid partnerships with the nearest facilities carrying blood stock whereby they will transfer some on the next transport to replace or augment what you use. A second approach is to arrange for medivac teams coming to pick up seriously bleeding patients to stop at the nearest blood center or nearest hospital to pick up units and bring them in. The Canadian colleague reports that she had also heard that British Columbia was piloting a blood exchange program out of their southern hospital labs to remote locations. This would be something to look into. Finally, the responding colleague concludes with advice to also keep a good stock of pentaspan on hand.

Please submit comments to the e-Network Forum.

Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator