Johns Hopkins All Children's Hospital Palmetto, Florida, United States
Background/Case Studies: In the fall of 2024, our facility, a 259-bed pediatric hospital comprising of a 97-bed Neonatal Intensive Care Unit (NICU), a 50-bed Cardiac and Pediatric ICU, a 28-bed Bone Marrow Transplant and Hematology/Oncology unit, and 69-medical-surgical beds with 15-specialized beds for the Congenital Diaphragmatic Hernia (CDH) unit was directly impacted by two hurricanes within a one month time span. Early preparation and anticipation of patient needs are critical to maintaining the transfusion support essential for our patients during such emergencies.
Study
Design/Methods: Two primary considerations in preparing for natural disasters are blood inventory management and adequate staffing across all phases of the event: preparation, response, and recovery. Ongoing communication with providers in all critical units helps identify patients likely to require transfusions, allowing us to place targeted orders with our blood center. Once road conditions become unsafe and the hospital enters lockdown status, blood products are allocated based on medical director approval to ensure availability throughout the storm’s duration.
Results/Findings: Our disaster response staffing model consists of three designated teams: preparation, “ride-out,” and recovery. This structure supports continuous coverage and coordination. However, despite thorough planning, we encountered unexpected challenges that threatened our ability to provide essential blood products to certain patient populations at our facility. Hurricane related damage disrupted the city’s water supply, rendering our x-ray irradiator inoperable, as it requires a continuous water flow to cool the x-ray tubes. This posed a significant risk to our immunocompromised patients, for whom irradiated blood is critical. Compounding the issue, our blood center, also located in the affected city, was similarly unable to irradiate blood products. Road closures further impeded efforts to obtain irradiated components from other sources. A contingency plan was developed to airlift irradiated blood via the hospital’s helicopter from unaffected regions of the state. Fortunately, the city restored water service before this measure was necessary. Conclusions: This experience highlighted vulnerabilities in our disaster preparedness. To mitigate similar risks in the future, we established a backup water supply for the irradiator’s cooling system and a plan to maintain a reserve stock of irradiated blood products. These measures will help ensure continuity of care during future hurricanes or other emergencies that impact infrastructure and logistics.
