save blood. save lives. blood conservation services helping you choose wisely. “don’t leave home...

Save Blood. Save Blood. Save Lives.Save Lives.

This presentation will cover:

The importance of completing a durable healthcare The importance of completing a durable healthcare power of attorneypower of attorney

Procedures & Therapies used at McLeodProcedures & Therapies used at McLeod

Blood Conservation Services helping you choose wisely.

Help you to complete your healthcareHelp you to complete your healthcare durable power durable power of attorney as neededof attorney as needed


The importance of a completed durable

healthcare power of attorney




• Unbaptized publisher

• Bad reaction to medicine and was in a medically induced coma for one month

• No medical directive or living will

• Court ruled against husband who is a JW in favor of her parents so that she could receive a transfusion

Case 1 in 2006



• Baptized publisher

• Ruptured ectopic pregnancy with significant blood loss

• Had completed medical directive

• While in severe pain, she stated that she refuses transfusion of whole blood or red blood cells but would accept platelets and plasma• Hospital personnel accepted that statement as a reversal of her written wishes

Case 2 in 2012


To make sure that your healthcare durable power

of attorney is a legal document:



All 4 pages must be kept together; therefore do not cut or tear apart your DPA


Fold and place in your wallet with the NO BLOOD logo clearly visible if possible

Please remember that your healthcare agent CANNOT witness your DPA

In SC:

Your name, address and date signed and those of the witnesses must be complete including the zip code

In SC:

Can be used for all non-JWs such as unbelieving spouses and adult children

Must be notarized

In NC:

Slight difference from SC and must also be notarized


What are blood fractions?

How are they used?


Blood Fractions


Red Blood Cells 40 -45%

Plasma 55%

White Blood Cells & Platelets

1%

Whole Blood is spun through a device called a centrifuge.

It becomes separated into four main parts.

Blood Fractions – What are they?



Whole Blood and its

Main Blood Components

are not accepted by

Level I patients.

The separation into these components are the beginning of a process called [Fraction]alization

Main Blood Components

Red Blood Cells 40 -45%

Plasma 55%

White Blood Cells & Platelets

1%



Fractions from Plasma


7%

ALBUMINFIBRINOGENGLOBULINS

CLOTTING FACTORS

91%WATER

Many blood fractions are derived from plasma. Through varying processes, plasma can also be broken down into proteins that include albumin, fibrinogen and globulin. Each one of these proteins can be used as treatment in various medical conditions.

Blood fractions from plasma are first heated up to 1400 F (pasteurization) for 10 hours and then cooled to temperatures as low as 210 F.

Then it is cooled between 21 - 26o F


Albumin

Protein extracted from plasma. Makes up to 4% of plasma.

Blood Conservation Services helping you choose wisely.Blood Conservation Services helping you choose wisely.

Plasma is heated to 140o F



When blood is lost from the body, the first step is to stop the bleeding.

The second step is to return the blood volume to the body. Albumin it added to an IV solution which aids in replacing the lost volume thereby allowing the remaining red blood cells to carry oxygen. Albumin is used as a volume expander to treat severe blood loss and burns.

Albumin

Blood Vessel

Albumin is found in plants, animals, and in foods such as milk and eggs, and in the milk of a nursing mother.

Eggs Whites

Animals

Plants

Small amounts of albumin are found in some erythropoietin (EPO) compounds. Currently, research to produce albumin, from non-blood plasma sources, is underway.



Immunoglobulins (Antibodies)Immunoglobulins are a type of protein found in plasma. They makes up to 3% of plasma. They are the body’s defense (immune system) against invading viruses and bacteria. Most adults have an immune system that helps to prevent or fight disease. Fetuses or babies up to 3 months old, do not produce antibodies. The fetus receives its protection from the placenta of the mother. Babies when born receive their immunity through breast milk. This is called passive immunity.



Immunoglobulins (Antibodies)Immunoglobulins are also used in some medicines for the treatment of certain infections, such as tetanus, dipththeria, rabies. It is also used to counteract the effects of snake or spider venom.





Fresh Frozen Plasma

Slow Thaw

Hard Spin to Separate

Clotting Factors and

Cryoprecipitate

Clotting factors and cryoprecipitate are another type of protein found in plasma and make up 1% of plasma. They are made by slowly thawing fresh frozen plasma and then spinning it through a centrifuge. Clotting factors are used to help the blood to clot to control bleeding. They are used in medical glues to seal wounds and some surgical openings. Cryoprecipitate is a combination of clotting factors that may be used to treat hemophilia and other excessive bleeding disorders.

Clotting Factors/Cryoprecipitate


Fractions from Red Blood Cells

•Hemoglobin

•Hemin


Currently, not used at McLeod



Fractions from White Blood Cells

InterferonsInterferons are a complex class of proteins which fight off viral infections and inflammation. They are used in the treatment of hepatitis and some HIV related infections and some forms of cancer.



Made from DNA technology, Neupogen stimulates bone marrow to increase white blood cells to fight against infection and inflammation. It may be used to treat patients receiving chemotherapy or bone marrow transplant recipients. It contains no human blood fractions.

Synthetic Immune Enhancer


Blood Fractions from Platelets

To date, there are no fractions derived from platelets as an alternative therapy to blood transfusion. Platelets are used to rapidly stop bleeding. Since platelets are a main blood component, it may not be acceptable to Level I patients.



Therapies for elective surgery


Erythropoietin (EPO) Stimulating Agents

Intravenous (IV) Iron

Cell Saver

Normal Blood Oxygen Levels

How erythropoietin (EPO) stimulating agents workBlood Conservation Services helping you choose wisely.


Injection of EPO Agent

4

Increases Erythropoietin

Production

5

Increase in Red Bone Marrow

6

7Increase in Red Blood Cells can

mean Increase in oxygen to

tissue

Normal Blood Oxygen Levels

Low oxygen in the blood

2

Kidney releases erythropoietin

3

1 Low Red Blood Cells or increased tissue demand for

oxygen

http://www.shutterstock.com/subscribe.mhtml

Blood Vessel

Spleen

Tissues

LiverBone Marrow

How intravenous (IV) iron work

Iron stored as Ferritin

Hemoglobin uses Iron

Red Blood Cells carry

more oxygen

Aging RBCs

Fe

Fe


FeFe


Step 1: Blood from surgery site is

mixed with solvent to keep from

clotting

1

Step 2: Blood is

filtered to remove large

clots and other debris

2

Step3: Blood is spun through a centrifuge

3

Step 4: Washed at the same

time

4

5 Step 5: Waste from red blood

cells are collected in receptacle

Step 6: Washed red blood cells

are collected for re-infusion

6

Step 7: Red blood cells are

reinfusion

7

How cell saver works




Other Types of Procedures


Hemodilution

Heart-Lung Machine

Dialysis

Epidural Blood Patch

Plasmapheresis

Labeling/Tagging

Platelet Gel



Plasmapheresis or Plasma Exchange

Plasmapheresis (pictured to the right) is a process where excess plasma is removed from the body. Then albumin or IV fluids may be used to replace the plasma that has been previously withdrawn. This process is used to treat many autoimmune diseases. A Level I patient would not receive another person’s plasma in the place of his or her own plasma.



Platelet Gels, Tissue Adhesives

A small amount of patient’s own blood is withdrawn, separated and then concentrated into a solution to form a gel. Platelet gel seals wounds which reduces bleeding.


RECAPWhat therapies are used for elective surgery?

What are blood fractions?


Erythropoeitin (EPO), Intravenous Iron (Venofer), and Cell Salvage

Blood fractions are proteins normally found in blood that are separated out for use as treatment. Human blood fractions include albumin, immunoglobulins, cryoprecipitate, clotting factors and interferons.


What will you do?

Will you accept all blood fractions?


Your choice is a personal matter!

Will you refuse all blood fractions?

Will you accept some blood fractions and refuse others?

save blood. save lives. blood conservation services helping you choose wisely. “don’t leave home...

Documents