CATES: US faces historical critical blood shortage

By Carol A. Cates, MSN, MBA, RN

Chief Nursing Officer

Odessa Regional Medical Center

During my career, I have developed more than one mental list of things I cling to or things I avoid. Lists like: “diseases I would never wish on my worst enemy,” “things I never want to experience again,” and “the miracles I have experienced.”

One the things that is very high on my “things I never want to experience again” list is being told by the blood bank, “we are out of blood.”

I have heard that phrase twice in my career, both of those patients had a condition called Disseminated Intravascular Coagulation (DIC). DIC is a very complicated condition where the blood clots where it shouldn’t clot and won’t clot where it should. Because of this, patients in severe DIC can bleed to death very quickly.

When it is severe, patients need blood and blood products, like platelets and plasma, in huge quantities so they can start making clots and to replace all the blood they lose. I have seen DIC patients get more than 30 units of blood and blood products in such situations. That is quite literally double to triple a person’s total blood volume. At its worst, a person in DIC can quite literally use up every unit of compatible blood in the blood bank, not just the blood bank at the facility where they are a patient, but at the regional blood bank level too.

When the blood bank runs out of blood, there is just nothing else we as health care providers can do to help them. There is no substitute for blood. Unfortunately, right now, it’s not just patients that need these huge quantities of blood that are at risk of running out of blood, it is all of us.

According to the American Association of Blood Banks, on the average day in the U.S. we need 36,000 units of red blood cells, 7,000 units of platelets, and 10,000 units of plasma. Normally, blood banks consider a 3 day supply of blood well prepared for any needs, but the American Association of Blood Banks Interorganizational Task Force on Domestic Disasters and Acts of Terrorism says that most of the blood banks in the US have dropped to a less than 1 day supply.

That has happened for several reasons. First, demand normally increases in the summer months, particularly around the 4th of July holiday because of traumatic injuries. Those traumas happen because people are out on the roads more, they are more active doing sports and other recreational activities, and unfortunately, some people chose to be on the roads and/or doing their recreational activities while using alcohol and/or mind altering drugs.

Second, as we recover from COVID, people are also starting to have the surgeries that were postponed during the worst of the pandemic, which also increases demand.

The worst part is the not the increased demand though, it’s that the supply has decreased dramatically at the same time the demand has gone up. Because large scale gatherings are still challenging with COVID restrictions in place, nationally, blood drives and blood donations are down. Vitalant, our local blood bank, stated that nationally their donations are down 20% from pre-pandemic volumes.

Right now, the U.S. is facing one of the worst blood shortages in history. Dr. Claudia Cohn, the medical director for the American Association of Blood Banks, stated that she has never seen the national blood supply so low. Knowing that, I am very concerned that far too many health care providers will have to hear those awful words, “we are out of blood” if our supply does not improve soon.

Please consider donating blood to help the supply needs now and consider adding blood donation to part of your regular routine. The basic requirements for blood donation are not difficult to meet.

Donors must be at least 16 years old, weigh at least 110 pounds, and be in good general health. Vitalant has specific eligibility requirements for the different type of blood or blood product donations as well as health restrictions that limit someone’s ability to donate on their website at

You can set up donation appointments, and begin the paperwork needed for blood donation on their website as well at Finally, if you can, host a blood drive. Vitalant has systems in place to be able to do a blood drive safely as we remain under some COVID restrictions. There is information on their website, about hosing a blood drive if you are interested in more details.