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Welcome to “Should I Call a Doctor?” The podcast where we dive into trending health topics to separate fact from fiction. We bring in experts to talk about all things health, to empower you with knowledge and answer your questions hosted by Inova Health.
Sam Elgawly (00:03):
Welcome to, should I call a doctor, the podcast where we dive into the questions you have about your health and today's trending health topics to separate fact from fiction. I'm one of your hosts, Dr. Sam Owly, an internal medicine physician at Inova.
Tracey Schroeder (00:16):
I'm Tracy Schroeder. I lead communications for Inova. Dr. Sam will give you the clinical perspective while I ask the questions that keep patients up at night.
Sam Elgawly (00:25):
Joining us today is Nicholas Lilly. He's our Senior Director of Inova Blood Donor Services. I would love to tell you all the things that he does, but I'll let him explain for himself. So, Nick, it's good to see
Nick Lilly (00:35):
You. Nice to see you both. Um, and thank you for having me here. You know, and I am the senior director here at, uh, blood Donor Services. I've been with Innova for working on 15 years. I've had the opportunity to lead a very strong group. Um, we like to call ourselves small but mighty. Mm-hmm . Um, so, uh, we're actually the largest hospital place, uh, blood center in the country. Uh, we see about 50,000 donors a year.
Tracey Schroeder (00:57):
So, welcome Nick. We're, we're really grateful that you're joining sam elgawlyus today and excited to talk about blood donation. A little bit of a difference from our usual, should I call it doctor topics, but important nonetheless, especially when you think about the blood shortage that's facing this country right now and how much we need new donors to step up and come. Talk a little bit about that. How do you guys, um, recruit new donors and what do you find to be the main reason people don't wanna donate?
Nick Lilly (01:24):
You know, when I think about blood donation, um, there are a lot of fallacies that exist out there. Um, people think if they have certain medical conditions, they can't donate. They think if, you know, I've got diabetes, oh, I can't donate blood, uh, I have high blood pressure. Oh no, I can't donate blood. No. We have medical requirements that, uh, we work on with our medical director, um, that are vetted and based off of those qualifications. Um, those really kind of delineate what's acceptable and what's not acceptable. Um, in terms of what we need in for donors, um, you know, really it's about community involvement and community efforts. Um, and so there are about four and a half million people that live in this area. Um, and so I already told you guys how many people actually donate with us on average every year. Um, and that kind of is commiserate with what you see across the country.
Nick Lilly (02:17):
So there's about 330 million people in the country, about seven people, 7 million people donate mm-hmm . Um, and so that ratio is very skewed. Um, and the one thing that, that I like to tell people is, you know, you can't wait for someone else to do it. You know, you have to do it. 'cause people don't realize blood is a drop. Um, we're regulated by the FDA, um, and we have other regulators that we work with. Um, however, because blood's a drug, it's something that people think, oh, you can just, you can make it, we can just go to the shelf. Let's make some more. No, it doesn't work quite that way. Um,
Tracey Schroeder (02:49):
You're dependent on those donations.
Nick Lilly (02:50):
That's right. That's right. All of our donations come from, uh, healthy volunteer donors. Um, and again, it can't be fabricated. Right. Um, so that's why I say, you know, it starts with each and every person that's eligible. Now in the general population, there are reasons why people can't donate, but about 60% of the overall population in the United States is eligible. Um, and the FDA is continuously looking at those, uh, regulations. Um, and that's continuously growing. So again, it just starts with each and every person. You have to try it can't hurt the track.
Tracey Schroeder (03:23):
And talk us through a little bit like what happens when you come to, to one of the centers to donate or you see a mobile blood drive. Let's tell our listeners what they can expect from that, because I think maybe people think it's more laborious or you know, it's gonna take longer or it's unsafe or, or maybe there's other misconceptions. So walk us through what that process is.
Nick Lilly (03:45):
So, you know, when you come in to donate, um, really we like to say, please give us 60 minutes. And that's, you know, just the standard, um, under progress, over deliver. So, uh, you walk in the door, um, you'll be, um, what we like to call, um, registered. Um, so someone will check you in, verify either that you have an appointment. If you don't, that's okay. We can work you in always. Um, then we'll ask you to fill out a form if you haven't already. Um, we're now on, um, an electronic system and that, uh, you know, you just walk in, you scan the Q QR code, um, you fill out 43, um, standardized questions that everyone will fill out. Uh, they'll then go into our screening area. Um, our team members will register them, check them in, um, introduce themselves, um, verify the type of donation that they would like to make and verify their eligibility, um, from an interval standpoint. Um, they'll then do, uh, health history and behavioral history reviews. Um, and then they'll do a mini physical. So they'll check their blood pressure, pulse temperature, and the hemoglobin level, verify that their arms are acceptable. Um, and then they'll take 'em over to phlebotomy area.
Tracey Schroeder (04:50):
Meaning you can see a vein. Yeah, well
Nick Lilly (04:52):
Just a little bit more than that even. So, you know, wanna make sure that there are no rashes, cuts, bruises, or anything like that.
Tracey Schroeder (04:58):
Got it. Okay.
Sam Elgawly (05:00):
I can definitely attest to what you said. I did. I donated a blood with you guys two to three months ago. I have to, I mean, that is one of the smoothest processes I have ever been through. That's good. It was incredibly efficient. The people knew what they were doing. Your phlebotomists or geniuses, I mean, it's like they could throw the needle across the room. and so lands in your vein . Um, it really was, it was an incredible process. And it is all the things you said. They're very thorough, they're very thoughtful. It's very specific questions. Your blood, of course is getting tested. Um, but then that's it. It's sit down, they, you know, put the band around your arm and the amount of blood that you guys get out of me in such a quick period of time, I remember looking, being like, oh my God, you're already done .
Sam Elgawly (05:41):
And that was it. So, um, so kudos to you guys. It really is a very well run service. And obviously the service that you are providing is so crucial. Which, and maybe this is an obvious question, but I think some people would still ask at the end of the day, if you had to say in a couple of sentences like, why is this so important? Like, why is donating blood so important? Why do we need blood? And then maybe also why is, why is there such a shortage more than before? 'cause it seems like it's standing out a little bit now.
Nick Lilly (06:14):
So again, we can't make blood that, that really is what it comes down to. You know, if pharmacy has a shortage, they can potentially find it somewhere else within the country. They're gonna get the medications that they need, but blood, you know, lemme take it several steps back. Alright, so there are, what are, what you consider community blood centers. We're all here for, you know, making sure that the population has what it needs in terms of blood products. Um, so we're actually part of a organization called BCA. Um, BCA has about 40 community blood centers. And that actually those blood centers collections actually represent, uh, probably about 60% of the country's blood. And Red Cross only really represents about 40%. Um, and so when you think about what we're doing specific to our community, we, again, we're the largest hospital based blood center in the country, but we're also servicing all the Nova hospitals.
Nick Lilly (07:08):
Um, we've got the Venice hospitals in Maryland. Uh, we've got, uh, Virginia Hospital Center. Uh, we've got, uh, blood projects that go to Georgetown, George Washington. Um, we're all throughout this area. Um, and about 90% of the products that are, are donated, um, with Inova are transfused in this area. So, so we represent 90% of the transfusions in this area. Got it. Um, so again, um, you know, when you think about why it's important to donate with us, it's because it's going to stay within our community. Um, and it really is about supporting our community. Mm-hmm . Um, the other thing that people don't realize and they don't think about, they say, oh, well you don't, you collect a lot of blood last month, so why do you need it now? Well, blood has a shelf life again, I that as a drug.
Tracey Schroeder (07:51):
I didn't know that before I worked in healthcare. What, this is a perfect ticket. Yes. Tell us a little bit about that and tell us. I think also what are the, what are the occasions that patients need blood? I don't think that's fully understood either.
Nick Lilly (08:03):
So, uh, again, if we're thinking about the shelf life specifically, uh, red cell has, uh, up to a 42 day shelf life. Um, and that's with an additive solution in there that it can continue to feed on and that sort of thing. Um, there are several different components I should also mention. Um, so when someone donates blood, we'll call it regular blood donation, they're donating whole blood. So whole blood's comprised of red blood cells, platelets, plasma, white blood cells. Now we remove white blood cells through a process called LR reduction because my white, white blood cells might be good for me, they might not be good for you, yours might be good for you. They won't, won't necessarily be good for me. Um, but we remove those white blood cells and so potentially we get, or we can save up to three lives, as we say, um,
Tracey Schroeder (08:47):
With one collection,
Nick Lilly (08:48):
Yes, with one collection potentially. That's great. Um, but again, uh, when we're thinking about those shelf life, um, so red blood cells, 42 days plasma, frozen, uh, one year. Uh, platelets. Yeah.
Sam Elgawly (09:01):
, I did not know that. Actually one year. That's a plasma frozen.
Nick Lilly (09:04):
Yeah. Um, but once it's, once it's uh, thawed. Yeah. As much shorter. Yep. Yeah. Um, and then when we, you think about platelets, that's our favorite, favorite topic. Um, so that only has a five day shelf life
Tracey Schroeder (09:17):
And why would somebody need platelets or plasma or just a regular blood donation?
Nick Lilly (09:22):
Uh, so alright, so we'll start with red cells. Yes. So, uh, red cells, you know, let's just think trauma mm-hmm . Um, if someone is in, uh, a dire situation, um, they've got, uh, some sort of bleeding condition. Um, I mean, even cancer patients, um, you know, when I think about platelets, um, that's really a cladding factor. So you're trying to stop the bleed. So that's also needed. Um, you do also see the need for platelets in cancer situations as well. Um, plasma really that's volume replacement. Um, so burn victims, um, sometimes need plasma. Sometimes plasma is just again, needed when, uh, you're transfusing the other products. So when I think about, um, these MTP, um, coolers that you may hear about from time to time in our art, so, uh, MTP is a massive transfusion protocol. Okay. Um, so when there's a trauma, um, you know, we have a specific in the blood bank, not at blood donor, but at the blood bank they have, uh, a container that has a specific set of products. So,
Tracey Schroeder (10:22):
Okay, if I made an appointment for tomorrow and I came in, is it the, the default is whole blood donation. That's what I would be giving.
Nick Lilly (10:29):
Yeah. So, so that's the default, uh, collection process. Uh, again, we ask you give us an hour, that particular part of the process, the collection portion takes 15 minutes.
Tracey Schroeder (10:38):
And if somebody came in to donate platelets, is that collection process still, you know, within the same 15 minutes? No.
Nick Lilly (10:45):
Uh, so, so for platelet collections, um, we do ask people to reserve a couple of hours. Okay. Um, now I will say from a collection standpoint, after we've done all those prequalifications that we talked about, the screening process, um, our average collection time is about 70 minutes. Uh, which isn't that long if you really think about it. I mean, it sounds long, but we have things to, for you to do. You can, you know, connect to the wifi, do your work, you can watch Netflix on your, your device. I mean, we even still have DVDs that you can Yeah. Watch right in front of yourself. Like
Sam Elgawly (11:19):
You're just sitting there, you're not doing, you're not occupied or
Tracey Schroeder (11:22):
Do something.
Sam Elgawly (11:23):
Yeah. Yeah. Process. Process. Why does it take, why did, because that is a significant change in time. Why is it, and I'm not trying to make it sound long, like you said, it's probably a lot shorter than it seems, but, you know, when I did, and I honestly now can't remember if I did whole blood or double red cell donation, but whatever it was, it was like not even 50 like from needle to, I was like, wait, you're done already. So what is the main reason why platelets takes longer?
Nick Lilly (11:45):
So when we think about our platelet donations and really what's called automated collections, um, that process is doing all the processing and collecting a large volume of those specific components. Hmm. Um, and so the important thing about platelet collection, which started back in 1978, um, at in Nova anyway, um, but the important thing about a platelet collection is that we can collect a high volume amount of platelets, perhaps the same amount that we would see from random donor platelets, which
Sam Elgawly (12:15):
Oh, I see. Mm-hmm
Nick Lilly (12:16):
. Random donor platelets will come from whole blood. Um, and so the way that you handle those products, um, it's a little bit different than the way that we handle our single donor platelets. So, um, for a random set of donor platelets to be transfused, you need collections from 46 people at a minimum. Um, and you can get that from one person on a platelet donation. Um, you know, truthfully, the efficiency of the, what we, the treatment instrument is the apheresis, uh, instrument that collects. Um, but the efficiency of that particular collection procedure, um, can actually draw three times that, um, if someone qualifies. So the same amount of products that you would collect in random platelets from about, anywhere from, uh, 12 or 14 to 18 whole blood donors, you can collect that from one person depending on how many
Sam Elgawly (13:05):
Oh my goodness. Wow. That is a tremendous difference. And
Nick Lilly (13:09):
So it's really actually three products. And those three products can be given to three patients, um, depending on how someone qualifies. That makes sense. But that collection procedure kind of runs on a draw and return phase. So when it draws blood is gonna draw about 400 milliliters of blood. And then the instrument has a center fusion. Um, well, essentially it's going to allow you to remove just the platelets. Yeah. And then in a separate cycle, um, we will
Sam Elgawly (13:37):
Just returns the rest
Nick Lilly (13:38):
To your body, return your red cells a portion of your red cells, um, and you know, some of your plasma, there's, there's some saline that goes along with that and some anticoagulants. Very safe. Keeps
Sam Elgawly (13:46):
A little commission. Yeah. little bit left behind.
Nick Lilly (13:49):
Um, and so it goes in drawing return phases of about 10 minutes or so. So every 10 or 15 minutes it's, it's gonna draw and return, draw and return, um, so that it's a safe and sound process. Um, and so again, when you think about that 70 minutes, um, you know, really it's only seven cycles. Um, and so it goes by really quick. Um, and, and you know, we have a very dedicated group. Um, one of our donors has donated, uh, apheresis almost 700 times.
Tracey Schroeder (14:19):
Oh my goodness. Oh wow. That is dedication. Yeah.
Nick Lilly (14:21):
Yeah. He's, he's a very dedicated person. We have many people that are in the 500, 400, 300 range.
Tracey Schroeder (14:28):
So Nick, for somebody listening today who's really inspired by this and sees the opportunity to help, how would they go about sort of making an appointment, setting time up to come in and give blood, and then how often can they do that?
Nick Lilly (14:40):
Um, you could give us a call, 1 8 6 6 2 5 6 6 3 7 2. Um, you can certainly go on our website, um, to in nova blood.org. Um, click on where can I donate or schedule an appointment. Now they can do that. Um, they can also reach out to us on social media. Um, that's another way, um, we even have texting , um, which hey, if you texted Nova to 9 9 9 7 7 7, uh, you'll be signed up for text alerts, um, associated specifically with blood donor.
Tracey Schroeder (15:08):
That's great. That's great. Yeah. Thanks Nick for being with us. It's clearly really critical that we continue to get the word out and make sure people know how important it is to donate blood. And so we really appreciate you helping, uh, us all learn more about the process.
Nick Lilly (15:23):
Absolutely, absolutely. Again, um, if you have time, uh, we are open seven days a week. , , we are probably in your neighborhood. Um, we've got three donor centers in, uh, Sterling, Annandale, and Centerville. Um, as well as, again, blood drives anywhere in a, we like to say a 45 mile radius of our Sterling location. So we'll go as far north as Baltimore, as far south as Fredericksburg, even though we're gonna Richmond next month. Oh wow. Um, and as far west as West Virginia. So, um, we're anywhere and everywhere. Um, and we'd like to come to where you are. Um, so again, if you are interested in getting your team members back to work or you'd like to have a, a health event or a community health event, um, hey, let's start with a blood drive. We have places where we can love it. Have you bring your team ? Yeah. That's great.
Tracey Schroeder (16:13):
So thank you Nick. Thank you Marc. Appreciate the time today. Thank
Nick Lilly (16:16):
You.
Tracey Schroeder (16:18):
Thanks for tuning in. We hope you enjoyed this episode. If you liked what you heard, be sure to subscribe.