Why plasma therapy? Seeking details cut down requests for blood at RIMS

NEW DELHI: Even before ICMR dropped plasma therapy from the

Covid

treatment protocol, asking hospitals seeking convalescent plasma to fill up a form detailing why therapy was recommended brought down requests to the blood bank in Ranchi Institute of Medical Sciences (RIMS) by almost half. The director of

RIMS

pointed out that this was proof that oversight could go a long way in tackling irrational treatment.


“Just the idea that you have to provide written justification for why you have prescribed plasma therapy makes doctors and hospitals careful. The idea that there is a written record of your treatment decision, which might or might not be audited,” explained RIMS director Dr Kameshwar

Prasad

.

In convalescent plasma therapy, plasma from patients who have recovered from Covid, which is rich in antibodies is transfused into Covid patients to induce immunity. However,

several studies

have shown that the treatment has no impact on mortality or severity of illness.

On an average, RIMS got about 36 requests per day before it brought in the form. On May 4, RIMS issued a form asking for detailed criteria on which the request for plasma was based. These included the name of the hospital and treating doctor, patient’s name and age, copy of

RT-PCR

test, time since onset of symptoms, ventilator mode if the patient was on ventilator, respiratory rate, oxygen level on room air and severity of the disease based on WHO guidelines.

The very next day, the number of requests fell to 18 and then to about a dozen. Now, after the new protocol removed plasma therapy for Covid treatment, RIMS gets barely two requests a day. “This shows the importance of proper studies evaluating therapies and the need for proper protocols which are communicated to the public effectively,” said Dr Prasad.

“When the requests fell by half, it was a huge relief not only for our blood bank staff, but also for patients’ families. It was obviously being used by private hospitals who, knowing that a patient might not survive, were trying to transfer the blame. Knowing how difficult it is to get convalescent plasma since appropriate blood group was difficult to find, they could say they were unable to save the patient as the family could not procure plasma,” said Dr Prasad.

“Politicians and bureaucrats were calling up seeking plasma for various patients. And suddenly it stopped after RIMS brought in the form and now we see hardly any requests,” said Atul

Gera

, a public health activist.

“The pressure was so high that an official given the power of a magistrate was appointed by the district administration at the blood bank to monitor and report the demand, supply and stock of plasma. We had cases of people dying within an hour or two after the hospital prescribed plasma. Why were they prescribing plasma for a patient whose condition was so serious? It is of no use when given at a late stage of the disease,” said Gera.

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