Using Blood Saving Apparatus With Restrictive Blood Transfusion

As expected, with war comes extensive injuries. During WWI, it took a wounded soldier about 24 hours to travel from the battlefield to a hospital. Many times, the soldiers did not live through that excruciating 24 hours. The wounds inflicted on many soldiers led to the development of new medical techniques and improvements (iWonder 2015). The quickly rising death toll during WWI led to the creation of blood transfusion techniques. Prior to WWI, blood transfusions were nearly impossible without cross-matching blood types. An article published by Medical History argues that, “Though the technique (blood transfusions) caused several deaths, it did save dozens of other men, proving its lifesaving

The market of human blood transfusions is broken down into different uses: Elective Surgery, Emergency Surgery and Trauma. However, Hemopure seems to be suitable only for trauma cases due to its characteristics and, again, high price. To understand the reason, it is important to notice that, actually, only 10% of the 500,000 trauma victims receives RBCs “in the field” or at the site of accident, and the remaining 95% of these people does not receive transfusions until they arrive at the hospital. This delay was often cited as a major factor to the 20,000 trauma deaths. Therefore, since the expected market share for Biopure is 25% and assuming that the total blood transfusions remain stable, the potential market size for Hemopure is approximately $350,000,000. This size is based on an average price of $700 multiplied by 2,000,000 units (around 4 blood units are needed for each Trauma case).

When I arrive to the Trauma ICU 4800 unit, all of the nurses were already being followed by other students. The nurse in charge had me follow several different nurses, so I was able to observed several different patient cases. The first patient had received a triple bypass open-heart surgery. The patient had received a creatinine blood test. The patient had a dialysis machine next to them, which was used to function as the kidneys since the patient’s kidneys were not functioning correctly. Also, the patient’s body temperature was lowered from having a taken cool liquids so the nurses were keeping him warm with a bair hugger, which was a machine that helped regulate the patient's’ body temperatures.

The nurse driven protocol was tested in 4 intensive care units. It included evidence-based orders for discontinuing, handling, and properly managing the catheters. One of the most important factors was the removal of the catheters in a timely manner. The data pre

Guidelines for the proper collection of blood cultures include many recommendations that exhibit quality and excellence. This paper’s purpose is to identify an evidence-based project (EBP) proposal for proper blood culture collection, especially in the emergency department setting by identifying the problems associated with blood culture draws, addressing the need for change in practice. Assessing the need for change in practice consists of identifying stakeholders, in the change process, collecting and analyzing data collected, identifying the problem and presenting outcomes and interventions for the problem (Larrabee, 2012).

Kevin Brown, the curator of the Alexander Fleming Laboratory Museum says “Men carried in their pockets a small metal tin. A precursor of First Aid kit. Inside contains a number of small phials of pain relief’s such as pure ether, morphine, and caffeine. At this juncture of WWI, it was thought that the best treatment was morphine, a cup of tea, and a cigarette” (Dubenskij, 2014). Carrying these small packets around definitely helped the soldiers by providing a pittance of energy whenever they are feeling low. Also said by Brown, “Men who lost limbs were given prosthetics and trained in various crafts they could do to earn a living. Before the First World War, they were ignored” this was referring after the use of Thomas Splint (Dubenskij, 2014). A contraption that is still used today to stabilize fractured femurs, prevent infection, and help knit bones back together. When used in WWI, it reduced the mortality fractures dramatically, reducing the number of soldiers dying. Prior to WWI, blood transfusions were rarely performed and a risky procedure. Transfusions are performed in instances of excessive blood loss or when a patient is incapable of making their own blood properly. This process can take from 1-4 hours by connecting an IV to a patient’s blood vessel (care, 2010). As a result, of the horrors of the First World War, blood transfusions became common. The medical team would safely keep these blood packs on ice and with the discovery of anticoagulants improved the ability to store blood (BBC, n.d.). The knowledge and skill to transfuse blood have grown. Since WWI, medicine has come to master the art of blood transfusions. The result of such growth is positive as thousands of patients across Canada have successfully benefitted with these medical inventions everyday

For the purposes of this paper, the author will only focus on National Patient Safety Goals 01.01.01: Identifying patients correctly and 01.03.01 Eliminate transfusion errors related to patient misidentification.

Keywords: intensive care, patient scenario, clinical practicum, pathophysiology, disease processes, interventions, diagnoses, assessments, health prevention, promotion, health outcomes

Intravenous (IV) fluids were bolusing; however, when blood pressure was only obtainable manually and revealed that her blood pressure was 74/34, the decision was made to send the patient to the intensive care unit (ICU). There, coagulation studies revealed an elevated PT, PTT, D-dimer, and a decreased fibrinogen count. She received a peripherally inserted central catheter (PICC), a transfusion of two units of packed red blood cells (PRBCs), as well as cryoprecipitate therapy during her treatment in the ICU.

The Oxyglobin and Hemopure substitutes developed by Biopure have an advantage over blood transfusions in many areas including blood type matching, universality in terms of donating, such as O+ blood recipients. The blood substitutes also had a much longer storage life of 2 years as opposed to the 6-week storage life of transfused blood. Furthermore, with the rise of diseases such as AIDS and increasing public concern about the same, blood substitutes also helped mitigate that risk. Baxter International and Northfield Laboratories-products sourced their blood substitutes from human blood whereas, Biopure sourced it from animal blood, cattle in particular. This put them in a better position than their competitors. Also Biopure’s Hemopure and Oxyglobin did not require refrigeration unlike its competitor’s products.

But nobody ever set any parameters on what to do if the hemoglobin ranged between 7 and 10. This left the physician to decide when to start a blood transfusion. The Johns Hopkins study revealed that because of this most physicians always erred in the side of “safety” by ordering a transfusion any time the hemoglobin was at or below 10.

In a publication of the Stanford University School of Medicine, held an article entitled “Against the Flow—What’s Behind the Decline in Blood Transfusions?” The author of that article, Sarah C. P. Williams, stated: “Over the past decade, a growing body of research has revealed that in hospitals around the world, donated blood is used more often, and in larger quantities, than is needed to help patients—both in operating rooms and hospital

Utilizing the five points mentioned would transition the information from the systematic review into practice. The review would identify as an evidence summary in the model, producing a more manageable quantity of information. It can then be translated as it is combined with clinical expertise and tailored to the clinical setting. The setting that would benefit the most from this change would be those in the critical care setting, as septic patients are in a critical state and are monitored closely. Having strong supporting evidence will make a substantial argument to change practices. Utilizing the data, combined with clinical expertise and experience, supports the changes needed to provide the most up to date, evidence based care. Clinical expertise regarding sepsis benefits the healthcare team in acknowledging other clinical data that could be used to determine fluid volume status, straying away from depending on central venous pressure. The goal would be to transition from using central venous pressure as a reliable indicator of fluid volume status to utilizing noninvasive cardiac output monitoring, when possible, and other clinical indicators. Another change would involve discrediting the validity of central venous pressure as a volume status indicator to clinicians. Mark, Monnet, and Teboul (2007) noted that 90% of intensivists use central venous pressure

I think Patient B is ineligible to donate blood for a few reasons. Although she is over the age and height, at 20 years old and 113 pounds. She also has a healthy diet and the medications she takes does not affect her eligibility to donate blood. Also, she is allowed to donate with a little high sodium and she only traveled to Florida, which is fine because it is not a Zika infected area. However she is unable to donate because her red blood cell count is low, which makes her unable to donate. Second, her hematocrit and hemoglobin are low, which you cannot donate if your hemoglobin is low. This is because hemoglobin can cause anemia, which can make a person to lose red blood cells from their body. Some recommendations is she should eat more

Interpretation of the fluid balance of hospitalized patients and prescription of intravenous fluids is one of the core clinical skills required for the practice of medicine in almost every specialty. Failure to follow the best practice guidelines can result in increased morbidity and mortality in cases of under prescription, over prescription or from prescribing the wrong type of fluids as highlighted in the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report about the perioperative mortality 1999. [1] The report emphasized on the importance of fluid prescription and recommended that it should be considered as important as drug prescription.