Accurate estimation of the need for blood products during MCIs is vital to providing these lifesaving resources when health care systems are under their greatest stress. In this era of terrorist activity, the most likely event will be a bombing, and thus we can learn a great deal from the experience gained in Israel where these incidents have been all too common. The article by Soffer et al provides a retrospective review of the use of PRBCs following 18 consecutive terrorist attacks in Tel Aviv between 1997 and 2005. They define a PRBC unit per admitted patient ratio index, which may be useful in planning the number of units of PRBCs to keep available for such events. More importantly, they also describe a standard operating procedure for notification and activation of the blood bank during an MCI that could be adapted for use by trauma systems throughout the world.
Bulger EM. Usage of Blood Products in Multiple-Casualty Incidents—Invited Critique. Arch Surg. 2008;143(10):989. doi:10.1001/archsurg.2008.3