Moscow shootings test new blood supply system

When Jason Hamilton’s weekend rage sent three of his five shooting victims to Moscow’s Gritman Medical Center, it was the first test of a new arrangement that provides more blood faster to the region’s rural hospitals in emergencies.

Gritman was among three Palouse hospitals to join Spokane’s Inland Northwest Blood Center in April, switching from an American Red Cross blood bank that had to ship blood from as far as Salt Lake City.

When the emergency calls came early Sunday, hospital officials had six units of O-negative blood ready for a hastily assembled team of four doctors and an extra operating room, said spokeswoman Jen Pfiffner.

Only two units of the universally accepted blood type were used to treat Latah County sheriff’s Deputy Brannon Jordan and engineering student Peter Husmann as they arrived in the emergency room. Although he was brought to the hospital, Moscow police Sgt. Lee Newbill already had died.

Also dead in the rampage were Paul Bauer, a church sexton, Hamilton’s wife, Crystal, and the shooter himself. Moscow police Officer Bill Shields was injured.

Gritman officials had been worried about the potential for multiple victims of car crashes, not shootings, when they joined hospitals in Colfax and Pullman in seeking a new supplier for some 1,500 units of blood each year.

“The car crash is a little more realistic to wrap our minds around,” Pfiffner said.

But the change to the Spokane blood center meant they and others were newly confident they could have handled all of the potential victims of the crisis, which could have stretched the trauma capacity of the region’s largest hospitals.

“Five or six victims? That would be nearly a disaster mode,” said John Reamer, director of Sacred Heart Medical Center’s emergency room and trauma services. “Can we handle more? Sure. We can handle more than that, but we wouldn’t want to.”

The three Palouse hospitals – Gritman, Pullman Regional Hospital in Pullman and Whitman Hospital and Medical Center in Colfax – had grown increasingly nervous about their ability to get blood quickly in emergencies.

There was enough blood to treat patients in the few serious trauma cases the hospitals had handled, but it wasn’t as abundant or as available as medical personnel would have preferred, officials said.

The American Red Cross was responsive, but there was no denying the distance between Boise or Salt Lake City and Moscow or Pullman was a problem, an agency representative acknowledged.

“Sometimes it’s like a Pony Express,” said Clare Matthias, regional spokeswoman for the American Red Cross, explaining that blood would be shipped north by plane, bus, car or whatever transport was available. “Often, that’s the best we can do.”

Each of the 25-bed Palouse hospitals stocks between four and eight units of type O-negative red blood cells close by for immediate use. In Pullman, up to 24 units – 10 of O-negative and 14 of O-positive – also are available, said Scott Adams, the hospital’s chief executive officer.

“There’s enough to handle one major casualty, but if there’s more than one, you have to look at the depot,” Adams said. “That’s where there’s a much larger supply.”

By mid-June, the Inland Northwest Blood Center plans to open a depot at the centrally located Pullman hospital that will ensure a steady source of all types of needed blood at the three hospitals, said Judi Young, the agency’s director. Cost for the new center and the staff to run it will be about $250,000 over two years, she said.

“We try to keep a five-day supply of blood for any of our hospitals,” said Young, whose agency supplies 33 hospitals in North Idaho and Eastern Washington. “Even with a four-day or a three-day supply, we can handle virtually anything that comes up.”

Sacred Heart and Deaconess medical centers, along other larger regional hospitals, keep a supply of between four and nine units of blood immediately available in or near their emergency rooms, officials said.

At Kootenai Medical Center, a half hour away from the Spokane blood bank, there are always nearly 100 units of blood available in the hospital’s lab, said spokeswoman Lisa Brown.

Lab officials say blood loss by potential shooting victims would be less than the two most worrisome causes: car crashes and spleen removals.

“That’s a big bleeder,” Brown said.

The Moscow shootings provided a grim reminder of the region’s worst shooting: the 1994 rampage at Fairchild Air Force Base that killed four and injured 22, said Dr. Jim Nania, director of the emergency department at Deaconess.

“We could handle many gunshot wounds and we did,” recalled Nania. “Your best chance of it going well is to have practice, planned and to be current.”

A steady and secure supply of blood is also necessary as communities large and small cope with new threats, said Jon Davis, chief executive at the Colfax hospital.

“The example of Moscow tells you what happens now in rural communities,” he said. “We’re seeing a different type of clientele mixing in with the people we’ve always served.”