This document provides guidelines for blood transfusion in obstetrics. It discusses strategies to reduce the risk of transfusion including optimizing hemoglobin levels during pregnancy through screening and treatment of anemia. The guidelines recommend oral iron as first-line treatment for iron deficiency and note parenteral iron may be needed if oral iron is not effective. The document establishes thresholds for anemia and transfusion based on hemoglobin levels and provides guidance on obtaining consent, product selection, and management of obstetric hemorrhage.
Blood transfusion in obstetrics: evidence based approachOsama Warda
This document discusses evidence-based guidelines for blood transfusion in obstetrics. It covers optimization of hemoglobin levels during pregnancy through treatment of anemia, strategies to minimize blood transfusions, indications for transfusion during labor/delivery and postpartum, and management of obstetric hemorrhage. General principles for transfusion include obtaining consent when possible and actively managing the third stage of labor to reduce blood loss and transfusion needs. Oral iron is the first-line treatment for iron deficiency anemia in pregnancy.
Blood transfusion in obstetric haemorrhageWafaa Benjamin
This document discusses blood transfusion in obstetric haemorrhage. It notes that while blood transfusion can be life-saving, it carries risks such as transfusion-transmitted infections, immunological reactions, and costs. Strict adherence to sampling, cross-matching, and administration procedures is important. Obstetric haemorrhage is a major cause of maternal mortality, and retrospective analyses often find transfusion was given "too little, too late" in fatal cases. The document provides guidance on identifying patients at risk, minimizing blood loss, managing anaemia, and appropriate use of blood components like red cells, platelets, and plasma for obstetric haemorrhage. It emphasizes the importance of clinical
Blood transfusion is an essential component for reducing maternal mortality from obstetric hemorrhage. Risks include transfusion-transmitted infections, immunological reactions, and administering the wrong blood component. In pregnancy, physiological changes like hemodilution complicate blood loss assessment. Blood transfusion is indicated for anemia with Hb <6 g/dL if delivery is imminent or <7 g/dL with signs of bleeding. For obstetric hemorrhage, rapid crystalloid resuscitation and blood component transfusion aiming for a 6:4:1 ratio of packed red blood cells to fresh frozen plasma to platelets is critical for management. Controversies around use of colloids versus crystalloids and
Blood Transfusion in Obstetrics Green-top Guideline 2015Aboubakr Elnashar
This document provides guidelines for blood transfusion in obstetrics. It discusses reducing the risks of transfusion, general transfusion principles, strategies to minimize banked blood use, management of obstetric hemorrhage with blood components, pharmacological strategies, and management of intrapartum, postpartum anemia and women who decline blood products. The guidelines recommend optimizing hemoglobin, using cell salvage and restrictive transfusion protocols to reduce banked blood use, and considering tranexamic acid and fibrinogen concentrate for major hemorrhage. Clinicians should have clear protocols for hemorrhage management and intrapartum anemia transfusion criteria.
The document discusses Patient Blood Management (PBM), which is a multidisciplinary approach to optimize care for patients who may need blood transfusions. It involves strategies before, during, and after surgery/procedures to minimize blood loss and transfusions. Key preoperative strategies include identifying and treating anemia, assessing bleeding risk, and considering preoperative autologous blood donation. Intraoperative strategies focus on techniques to reduce blood loss like cell salvage and tranexamic acid. Postoperative care emphasizes continued efforts to minimize blood loss and optimize physiology. The overall goals are to improve patient outcomes, reduce costs, and ensure an adequate blood supply.
Blood transfusion guidelines provide recommendations for appropriate clinical use of blood and components to reduce risks. The risks of transfusion can be lowered through effective donor selection, screening, testing, component separation, storage, and clinical use. Transfusion is recommended when the hemoglobin is less than 7g/dL or the platelet count is less than 10,000/uL, depending on the clinical situation. Alternatives to allogenic transfusion include autologous donation prior to surgery, acute normovolemic hemodilution, erythropoietin, and blood salvage to reduce transfusion needs.
This document provides clinical practice guidelines for blood conservation strategies in cardiac surgery from the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists. It recommends various preoperative, intraoperative, and postoperative interventions to reduce bleeding and blood transfusions during cardiac procedures. These include discontinuing antiplatelet agents preoperatively, using antifibrinolytics intraoperatively, and employing blood salvage techniques. The guidelines provide evidence and recommendations for different blood derivative products and perfusion strategies to optimize blood conservation.
- The document provides guidance on managing patients undergoing massive transfusion, defined as replacing total blood volume (≥10 units of red cells) within 24 hours.
- It outlines initial resuscitation steps, requesting specific blood products like red cells, platelets, fresh frozen plasma and cryoprecipitate based on lab tests, and complications to monitor like hypothermia, hypocalcemia and ARDS.
- Key points stressed include repeating lab tests to guide treatment, switching from O negative to specific blood once the patient's type is known, using a blood warmer for rapid transfusion, and considering pharmacological agents and cell salvage to reduce bleeding if available.
Blood transfusion in obstetrics: evidence based approachOsama Warda
This document discusses evidence-based guidelines for blood transfusion in obstetrics. It covers optimization of hemoglobin levels during pregnancy through treatment of anemia, strategies to minimize blood transfusions, indications for transfusion during labor/delivery and postpartum, and management of obstetric hemorrhage. General principles for transfusion include obtaining consent when possible and actively managing the third stage of labor to reduce blood loss and transfusion needs. Oral iron is the first-line treatment for iron deficiency anemia in pregnancy.
Blood transfusion in obstetric haemorrhageWafaa Benjamin
This document discusses blood transfusion in obstetric haemorrhage. It notes that while blood transfusion can be life-saving, it carries risks such as transfusion-transmitted infections, immunological reactions, and costs. Strict adherence to sampling, cross-matching, and administration procedures is important. Obstetric haemorrhage is a major cause of maternal mortality, and retrospective analyses often find transfusion was given "too little, too late" in fatal cases. The document provides guidance on identifying patients at risk, minimizing blood loss, managing anaemia, and appropriate use of blood components like red cells, platelets, and plasma for obstetric haemorrhage. It emphasizes the importance of clinical
Blood transfusion is an essential component for reducing maternal mortality from obstetric hemorrhage. Risks include transfusion-transmitted infections, immunological reactions, and administering the wrong blood component. In pregnancy, physiological changes like hemodilution complicate blood loss assessment. Blood transfusion is indicated for anemia with Hb <6 g/dL if delivery is imminent or <7 g/dL with signs of bleeding. For obstetric hemorrhage, rapid crystalloid resuscitation and blood component transfusion aiming for a 6:4:1 ratio of packed red blood cells to fresh frozen plasma to platelets is critical for management. Controversies around use of colloids versus crystalloids and
Blood Transfusion in Obstetrics Green-top Guideline 2015Aboubakr Elnashar
This document provides guidelines for blood transfusion in obstetrics. It discusses reducing the risks of transfusion, general transfusion principles, strategies to minimize banked blood use, management of obstetric hemorrhage with blood components, pharmacological strategies, and management of intrapartum, postpartum anemia and women who decline blood products. The guidelines recommend optimizing hemoglobin, using cell salvage and restrictive transfusion protocols to reduce banked blood use, and considering tranexamic acid and fibrinogen concentrate for major hemorrhage. Clinicians should have clear protocols for hemorrhage management and intrapartum anemia transfusion criteria.
The document discusses Patient Blood Management (PBM), which is a multidisciplinary approach to optimize care for patients who may need blood transfusions. It involves strategies before, during, and after surgery/procedures to minimize blood loss and transfusions. Key preoperative strategies include identifying and treating anemia, assessing bleeding risk, and considering preoperative autologous blood donation. Intraoperative strategies focus on techniques to reduce blood loss like cell salvage and tranexamic acid. Postoperative care emphasizes continued efforts to minimize blood loss and optimize physiology. The overall goals are to improve patient outcomes, reduce costs, and ensure an adequate blood supply.
Blood transfusion guidelines provide recommendations for appropriate clinical use of blood and components to reduce risks. The risks of transfusion can be lowered through effective donor selection, screening, testing, component separation, storage, and clinical use. Transfusion is recommended when the hemoglobin is less than 7g/dL or the platelet count is less than 10,000/uL, depending on the clinical situation. Alternatives to allogenic transfusion include autologous donation prior to surgery, acute normovolemic hemodilution, erythropoietin, and blood salvage to reduce transfusion needs.
This document provides clinical practice guidelines for blood conservation strategies in cardiac surgery from the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists. It recommends various preoperative, intraoperative, and postoperative interventions to reduce bleeding and blood transfusions during cardiac procedures. These include discontinuing antiplatelet agents preoperatively, using antifibrinolytics intraoperatively, and employing blood salvage techniques. The guidelines provide evidence and recommendations for different blood derivative products and perfusion strategies to optimize blood conservation.
- The document provides guidance on managing patients undergoing massive transfusion, defined as replacing total blood volume (≥10 units of red cells) within 24 hours.
- It outlines initial resuscitation steps, requesting specific blood products like red cells, platelets, fresh frozen plasma and cryoprecipitate based on lab tests, and complications to monitor like hypothermia, hypocalcemia and ARDS.
- Key points stressed include repeating lab tests to guide treatment, switching from O negative to specific blood once the patient's type is known, using a blood warmer for rapid transfusion, and considering pharmacological agents and cell salvage to reduce bleeding if available.
Role of transfusion medicine in hematopoietic stem cellFigo Khan
The role of transfusion medicine in hematopoietic stem cell transplantation involves donor evaluation and stem cell collection, processing, cryopreservation, thawing, and infusion. Transfusion medicine specialists ensure proper HLA typing and immunohematologic compatibility between donors and recipients. They collect stem cells via bone marrow aspiration, peripheral blood apheresis, or umbilical cord blood collection. Collected stem cells are processed, cryopreserved, thawed as needed, and infused into recipients. Transfusion medicine specialists also provide transfusion support and monitor for engraftment and complications related to ABO blood group compatibility.
The document summarizes guidelines from the 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. It discusses recommendations for various preoperative, intraoperative, and postoperative interventions to reduce blood loss and transfusions during cardiac procedures. The guidelines classify recommendations into different evidence-based classes and assign levels of evidence. Areas addressed include management of antiplatelet drugs, use of blood derivatives, minimally invasive procedures, blood salvage techniques, and creation of multidisciplinary blood management teams.
This document provides guidelines for blood and blood component transfusion. It discusses the various blood components, quality control parameters, rationale for transfusion in different clinical settings, transfusion guidelines including blood group shifting, use of leukoreduced and irradiated blood products, and the impact of oral antiplatelet therapy. It aims to update best practices for blood transfusion safety.
- The study observed FFP transfusion practices over 12 months in 17 Italian NICUs, finding that 8.2% of newborns received FFP transfusions.
- 60% of FFP transfusions were non-compliant with published guidelines, and 63% received FFP prophylactically without bleeding episodes.
- Coagulation tests like PT, aPTT, and fibrinogen levels did not predict subsequent clinical hemorrhage among those who received FFP transfusions.
BLOOD & BLOOD COMPONENTS IN OBSTETRICS BY DR SHASHWAT JANIDR SHASHWAT JANI
This document provides information from Dr. Shashwat Jani regarding obstetric hemorrhage and blood transfusion. It discusses the main causes of maternal morbidity and mortality as chronic anemia and major obstetric hemorrhage. It then outlines reasons why mothers die due to hemorrhage, including inadequate resources, failure to prepare, delays in recognition and treatment, and unavailable expertise. The document also summarizes different blood products that can be used for transfusion including packed red cells, fresh frozen plasma, platelets, and cryoprecipitate. It provides indications, dosing, and guidelines for use of each component.
Post parathyroidectomy hypocalcemia dng 2019prof.osama elshahataFAARRAG
This document discusses post-parathyroidectomy hypocalcemia. It begins with an introduction that defines secondary hyperparathyroidism and describes how it is often treated with surgery in the form of parathyroidectomy. It then discusses operative strategies for parathyroidectomy including total parathyroidectomy with autotransplantation. Risk factors for post-operative hypocalcemia are presented. The document concludes with a discussion of management strategies and challenges for treating post-operative hypocalcemia.
reduction of blood loss in burn surgerySumer Yadav
The document discusses techniques to reduce blood loss during burn surgery, including:
1) Infiltrating burn wounds and skin graft donor sites with an epinephrine-saline solution, which significantly reduced mean total blood units transfused and units transfused intraoperatively.
2) Applying tourniquets to limbs during excision, along with soaking exposed tissues in epinephrine solutions, which reduced estimated blood loss to 123 mL per percentage of body surface area excised compared to 211 mL without these techniques.
3) Staged high-dose epinephrine infiltration is also effective, with children losing an average of 0.98% of their blood volume per percentage of body surface excised, and
Dr. Shubha Allard's presentation covered blood transfusion safety, optimization, and new advances. She discussed how NHS Blood and Transplant supplies over 2 million units of blood per year in the UK. Blood safety is ensured through a safe transfusion process and safe blood components. Regulations and guidelines from the WHO, EU, and UK help ensure high standards for blood collection, testing, storage and transfusion. New technologies allow for extended blood typing and molecular matching to reduce transfusion risks like alloimmunization.
This document discusses transfusion and massive transfusion protocols. It provides a case study of a patient who suffered injuries from a motorcycle accident and received multiple blood transfusions. It then outlines lessons learned, including the importance of massive transfusion protocols, transfusion triggers, transfusion ratios, and the role of tranexamic acid. It recommends hospitals develop massive transfusion protocols and lists critical parameters that should be measured early and frequently for patients receiving massive transfusions, such as temperature, acid-base status, coagulation factors, and hematologic values.
1) Blood conservation strategies are important in cardiac surgery to reduce bleeding and transfusions which can increase mortality and morbidity.
2) Preoperative interventions include managing antiplatelet drugs and anticoagulants, correcting anemia, and using drugs to increase red cell mass.
3) Intraoperative techniques involve autologous blood donation, maintaining normothermia, pharmacological agents like tranexamic acid, and restrictive transfusion triggers.
4) Close monitoring of bleeding and vital signs is also important intraoperatively to guide transfusions which should be a last resort.
Blood a conversation about conservation ex ss 1010113ess_online
This document summarizes a presentation on blood conservation and patient blood management. It discusses the need to conserve the blood supply due to diminishing donor pools and increasing demand. Current strategies to reduce blood transfusions include anemia management, cell salvage techniques, and restrictive transfusion guidelines. Future strategies may involve oxygen carrying solutions, stem cell derived blood, and group conversion. The presentation emphasizes patient blood management as a multidisciplinary approach to optimizing patient care and blood utilization.
1. The document provides an overview of transfusion medicine, including the procurement and processing of blood components, their clinical uses, adverse effects, and good transfusion practices.
2. Blood donations are screened and tested for infectious agents before being processed into components like red blood cells, platelets, and plasma. Compatibility must be ensured when selecting components for transfusion.
3. Key aspects of safe transfusion include properly identifying the patient, prescribing transfusions only when benefits outweigh risks, obtaining informed consent, and monitoring for adverse events during and after transfusion. Guidelines aim to optimize clinical outcomes while minimizing risks.
This document discusses obstetric haemorrhage, which is a leading cause of maternal mortality. It defines antepartum haemorrhage (APH) as bleeding from the genital tract between 20 weeks of pregnancy and labour onset. APH complicates 2-5% of pregnancies and can be caused by placenta praevia, placental abruption, or cervical/lower genital tract bleeding. Women presenting with APH require prompt assessment and treatment to control bleeding, restore blood volume, and diagnose and treat the underlying cause. This is especially important for major APH cases requiring resuscitation with blood transfusions.
This document provides information about blood transfusion, including its definition, purposes, components, blood grouping and cross matching, types of transfusions, general instructions, and complications. Blood transfusion involves collecting blood from a donor and administering it to a recipient. It can be used to treat anemia, restore blood volume after hemorrhaging, and provide antibodies or clotting factors. Blood components include whole blood, packed red blood cells, plasma, platelets, and cryoprecipitate. Cross matching must ensure compatibility of blood types and Rh factor. Potential complications include acute and delayed hemolytic reactions, circulatory overload, and infections.
This document discusses a case of a 20-year-old woman who developed a large mechanical heart valve thrombosis after stopping anticoagulation during pregnancy and childbirth. 3D echocardiography clearly showed the large thrombus blocking the valve. She was referred for urgent valve replacement surgery. The document then provides 3 key take home messages: 1) Obstructive mechanical valve thrombosis should be suspected in patients with symptoms and inadequate anticoagulation and urgent surgery is often needed. 2) Younger patients require careful consideration of valve type due to risks of each. 3) Anticoagulation regimens during pregnancy aim to balance risks of thrombosis and bleeding but require strict control and monitoring.
Endoscopy in patients on antiplatelet or anticoagulant therapy.attiasalman1
This document discusses guidelines for managing anticoagulant and antiplatelet medications before and after gastrointestinal endoscopic procedures. It addresses which procedures require stopping medications, how to classify patient thrombosis risk, when to stop and restart medications, and special considerations for emergent bleeding situations. Key points include classifying endoscopic procedures and patient thrombosis risk as low or high, recommendations to stop or continue various medications before low-risk versus high-risk procedures, and guidance on reversing anticoagulation effects or providing alternate medications for emergency bleeding situations.
Introduction to Apheresis (Dr. Nashwa Elsayed)Nashwa Elsayed
This document provides an overview of apheresis, including:
- Apheresis involves separating blood components using centrifugation or filtration and returning the remaining blood to the donor or patient.
- It has been used since ancient times and modern techniques from the 1950s use continuous flow machines.
- Apheresis can collect blood components from healthy donors or remove components from patients for therapeutic purposes.
- Methods include centrifugation, membrane filtration, adsorption columns, and photopheresis. Considerations for the procedure include donor criteria, testing, and vascular access. Complications may include citrate toxicity which can be prevented or treated.
This guideline from the ASGE addresses the management of antithrombotic agents for patients undergoing GI endoscopy. It discusses balancing the risks of bleeding from endoscopic procedures against the risks of thromboembolic events if antithrombotic therapy is interrupted. It provides tables classifying the bleeding risks of different endoscopic procedures and the thromboembolic risks of different patient conditions. The guideline aims to help endoscopists consider procedure risks, patient risks, and effects of antithrombotic drugs on bleeding when deciding whether antithrombotic therapy should be continued or interrupted for a given patient undergoing a specific endoscopic procedure.
This document discusses the history and process of blood transfusion. Some key points:
- Blood transfusion began in the 17th century with animal experiments, and the first human transfusion was performed in 1818 to treat postpartum hemorrhage.
- Karl Landsteiner discovered the ABO blood group system in 1901, an important breakthrough that explained why some transfusions were fatal.
- For a transfusion, blood is typically obtained from voluntary donors and tested for infections like HIV, hepatitis, syphilis and malaria before use. It is also typed for blood group.
- Whole blood can be used or separated into components like packed red blood cells, plasma, platelets, which are used
- Anaemia in pregnancy is defined as haemoglobin levels below certain thresholds depending on trimester. Oral iron is usually the first treatment, with parenteral iron or blood transfusion indicated if oral iron is not effective.
- Active management of the third stage of labour and delivery in hospital for high risk women can help minimize blood loss. Blood transfusions require consent but in emergencies it can be obtained retrospectively.
- For major obstetric haemorrhage, protocols should replace blood components before fluids and aim for specific haemoglobin, platelet and coagulation targets through transfusion of red blood cells, plasma, platelets and cryoprecipitate. Recombinant factor VIIa may be considered for refract
This document provides guidelines for blood transfusion in clinical practice. It discusses the principles of transfusion medicine including avoiding unnecessary transfusions and using alternatives when possible. It provides triggers for transfusing red blood cells, fresh frozen plasma, cryoprecipitate and platelets based on hemoglobin, coagulation factor and platelet count levels. It also gives specific guidelines for transfusing patients with sickle cell disease, thalassemia, neonates and in emergency situations. The risks of transfusion are weighed against the benefits of maintaining adequate oxygen-carrying capacity and hemostasis.
Role of transfusion medicine in hematopoietic stem cellFigo Khan
The role of transfusion medicine in hematopoietic stem cell transplantation involves donor evaluation and stem cell collection, processing, cryopreservation, thawing, and infusion. Transfusion medicine specialists ensure proper HLA typing and immunohematologic compatibility between donors and recipients. They collect stem cells via bone marrow aspiration, peripheral blood apheresis, or umbilical cord blood collection. Collected stem cells are processed, cryopreserved, thawed as needed, and infused into recipients. Transfusion medicine specialists also provide transfusion support and monitor for engraftment and complications related to ABO blood group compatibility.
The document summarizes guidelines from the 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. It discusses recommendations for various preoperative, intraoperative, and postoperative interventions to reduce blood loss and transfusions during cardiac procedures. The guidelines classify recommendations into different evidence-based classes and assign levels of evidence. Areas addressed include management of antiplatelet drugs, use of blood derivatives, minimally invasive procedures, blood salvage techniques, and creation of multidisciplinary blood management teams.
This document provides guidelines for blood and blood component transfusion. It discusses the various blood components, quality control parameters, rationale for transfusion in different clinical settings, transfusion guidelines including blood group shifting, use of leukoreduced and irradiated blood products, and the impact of oral antiplatelet therapy. It aims to update best practices for blood transfusion safety.
- The study observed FFP transfusion practices over 12 months in 17 Italian NICUs, finding that 8.2% of newborns received FFP transfusions.
- 60% of FFP transfusions were non-compliant with published guidelines, and 63% received FFP prophylactically without bleeding episodes.
- Coagulation tests like PT, aPTT, and fibrinogen levels did not predict subsequent clinical hemorrhage among those who received FFP transfusions.
BLOOD & BLOOD COMPONENTS IN OBSTETRICS BY DR SHASHWAT JANIDR SHASHWAT JANI
This document provides information from Dr. Shashwat Jani regarding obstetric hemorrhage and blood transfusion. It discusses the main causes of maternal morbidity and mortality as chronic anemia and major obstetric hemorrhage. It then outlines reasons why mothers die due to hemorrhage, including inadequate resources, failure to prepare, delays in recognition and treatment, and unavailable expertise. The document also summarizes different blood products that can be used for transfusion including packed red cells, fresh frozen plasma, platelets, and cryoprecipitate. It provides indications, dosing, and guidelines for use of each component.
Post parathyroidectomy hypocalcemia dng 2019prof.osama elshahataFAARRAG
This document discusses post-parathyroidectomy hypocalcemia. It begins with an introduction that defines secondary hyperparathyroidism and describes how it is often treated with surgery in the form of parathyroidectomy. It then discusses operative strategies for parathyroidectomy including total parathyroidectomy with autotransplantation. Risk factors for post-operative hypocalcemia are presented. The document concludes with a discussion of management strategies and challenges for treating post-operative hypocalcemia.
reduction of blood loss in burn surgerySumer Yadav
The document discusses techniques to reduce blood loss during burn surgery, including:
1) Infiltrating burn wounds and skin graft donor sites with an epinephrine-saline solution, which significantly reduced mean total blood units transfused and units transfused intraoperatively.
2) Applying tourniquets to limbs during excision, along with soaking exposed tissues in epinephrine solutions, which reduced estimated blood loss to 123 mL per percentage of body surface area excised compared to 211 mL without these techniques.
3) Staged high-dose epinephrine infiltration is also effective, with children losing an average of 0.98% of their blood volume per percentage of body surface excised, and
Dr. Shubha Allard's presentation covered blood transfusion safety, optimization, and new advances. She discussed how NHS Blood and Transplant supplies over 2 million units of blood per year in the UK. Blood safety is ensured through a safe transfusion process and safe blood components. Regulations and guidelines from the WHO, EU, and UK help ensure high standards for blood collection, testing, storage and transfusion. New technologies allow for extended blood typing and molecular matching to reduce transfusion risks like alloimmunization.
This document discusses transfusion and massive transfusion protocols. It provides a case study of a patient who suffered injuries from a motorcycle accident and received multiple blood transfusions. It then outlines lessons learned, including the importance of massive transfusion protocols, transfusion triggers, transfusion ratios, and the role of tranexamic acid. It recommends hospitals develop massive transfusion protocols and lists critical parameters that should be measured early and frequently for patients receiving massive transfusions, such as temperature, acid-base status, coagulation factors, and hematologic values.
1) Blood conservation strategies are important in cardiac surgery to reduce bleeding and transfusions which can increase mortality and morbidity.
2) Preoperative interventions include managing antiplatelet drugs and anticoagulants, correcting anemia, and using drugs to increase red cell mass.
3) Intraoperative techniques involve autologous blood donation, maintaining normothermia, pharmacological agents like tranexamic acid, and restrictive transfusion triggers.
4) Close monitoring of bleeding and vital signs is also important intraoperatively to guide transfusions which should be a last resort.
Blood a conversation about conservation ex ss 1010113ess_online
This document summarizes a presentation on blood conservation and patient blood management. It discusses the need to conserve the blood supply due to diminishing donor pools and increasing demand. Current strategies to reduce blood transfusions include anemia management, cell salvage techniques, and restrictive transfusion guidelines. Future strategies may involve oxygen carrying solutions, stem cell derived blood, and group conversion. The presentation emphasizes patient blood management as a multidisciplinary approach to optimizing patient care and blood utilization.
1. The document provides an overview of transfusion medicine, including the procurement and processing of blood components, their clinical uses, adverse effects, and good transfusion practices.
2. Blood donations are screened and tested for infectious agents before being processed into components like red blood cells, platelets, and plasma. Compatibility must be ensured when selecting components for transfusion.
3. Key aspects of safe transfusion include properly identifying the patient, prescribing transfusions only when benefits outweigh risks, obtaining informed consent, and monitoring for adverse events during and after transfusion. Guidelines aim to optimize clinical outcomes while minimizing risks.
This document discusses obstetric haemorrhage, which is a leading cause of maternal mortality. It defines antepartum haemorrhage (APH) as bleeding from the genital tract between 20 weeks of pregnancy and labour onset. APH complicates 2-5% of pregnancies and can be caused by placenta praevia, placental abruption, or cervical/lower genital tract bleeding. Women presenting with APH require prompt assessment and treatment to control bleeding, restore blood volume, and diagnose and treat the underlying cause. This is especially important for major APH cases requiring resuscitation with blood transfusions.
This document provides information about blood transfusion, including its definition, purposes, components, blood grouping and cross matching, types of transfusions, general instructions, and complications. Blood transfusion involves collecting blood from a donor and administering it to a recipient. It can be used to treat anemia, restore blood volume after hemorrhaging, and provide antibodies or clotting factors. Blood components include whole blood, packed red blood cells, plasma, platelets, and cryoprecipitate. Cross matching must ensure compatibility of blood types and Rh factor. Potential complications include acute and delayed hemolytic reactions, circulatory overload, and infections.
This document discusses a case of a 20-year-old woman who developed a large mechanical heart valve thrombosis after stopping anticoagulation during pregnancy and childbirth. 3D echocardiography clearly showed the large thrombus blocking the valve. She was referred for urgent valve replacement surgery. The document then provides 3 key take home messages: 1) Obstructive mechanical valve thrombosis should be suspected in patients with symptoms and inadequate anticoagulation and urgent surgery is often needed. 2) Younger patients require careful consideration of valve type due to risks of each. 3) Anticoagulation regimens during pregnancy aim to balance risks of thrombosis and bleeding but require strict control and monitoring.
Endoscopy in patients on antiplatelet or anticoagulant therapy.attiasalman1
This document discusses guidelines for managing anticoagulant and antiplatelet medications before and after gastrointestinal endoscopic procedures. It addresses which procedures require stopping medications, how to classify patient thrombosis risk, when to stop and restart medications, and special considerations for emergent bleeding situations. Key points include classifying endoscopic procedures and patient thrombosis risk as low or high, recommendations to stop or continue various medications before low-risk versus high-risk procedures, and guidance on reversing anticoagulation effects or providing alternate medications for emergency bleeding situations.
Introduction to Apheresis (Dr. Nashwa Elsayed)Nashwa Elsayed
This document provides an overview of apheresis, including:
- Apheresis involves separating blood components using centrifugation or filtration and returning the remaining blood to the donor or patient.
- It has been used since ancient times and modern techniques from the 1950s use continuous flow machines.
- Apheresis can collect blood components from healthy donors or remove components from patients for therapeutic purposes.
- Methods include centrifugation, membrane filtration, adsorption columns, and photopheresis. Considerations for the procedure include donor criteria, testing, and vascular access. Complications may include citrate toxicity which can be prevented or treated.
This guideline from the ASGE addresses the management of antithrombotic agents for patients undergoing GI endoscopy. It discusses balancing the risks of bleeding from endoscopic procedures against the risks of thromboembolic events if antithrombotic therapy is interrupted. It provides tables classifying the bleeding risks of different endoscopic procedures and the thromboembolic risks of different patient conditions. The guideline aims to help endoscopists consider procedure risks, patient risks, and effects of antithrombotic drugs on bleeding when deciding whether antithrombotic therapy should be continued or interrupted for a given patient undergoing a specific endoscopic procedure.
This document discusses the history and process of blood transfusion. Some key points:
- Blood transfusion began in the 17th century with animal experiments, and the first human transfusion was performed in 1818 to treat postpartum hemorrhage.
- Karl Landsteiner discovered the ABO blood group system in 1901, an important breakthrough that explained why some transfusions were fatal.
- For a transfusion, blood is typically obtained from voluntary donors and tested for infections like HIV, hepatitis, syphilis and malaria before use. It is also typed for blood group.
- Whole blood can be used or separated into components like packed red blood cells, plasma, platelets, which are used
- Anaemia in pregnancy is defined as haemoglobin levels below certain thresholds depending on trimester. Oral iron is usually the first treatment, with parenteral iron or blood transfusion indicated if oral iron is not effective.
- Active management of the third stage of labour and delivery in hospital for high risk women can help minimize blood loss. Blood transfusions require consent but in emergencies it can be obtained retrospectively.
- For major obstetric haemorrhage, protocols should replace blood components before fluids and aim for specific haemoglobin, platelet and coagulation targets through transfusion of red blood cells, plasma, platelets and cryoprecipitate. Recombinant factor VIIa may be considered for refract
This document provides guidelines for blood transfusion in clinical practice. It discusses the principles of transfusion medicine including avoiding unnecessary transfusions and using alternatives when possible. It provides triggers for transfusing red blood cells, fresh frozen plasma, cryoprecipitate and platelets based on hemoglobin, coagulation factor and platelet count levels. It also gives specific guidelines for transfusing patients with sickle cell disease, thalassemia, neonates and in emergency situations. The risks of transfusion are weighed against the benefits of maintaining adequate oxygen-carrying capacity and hemostasis.
This document provides guidelines for managing patients with acute lower gastrointestinal bleeding (LGIB). It recommends initially assessing the patient's hemodynamic status and performing resuscitation if needed. Risk stratification should then be done to determine if the patient is at high or low risk of adverse outcomes. For most patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 hours of presentation after adequate bowel preparation. Endoscopic hemostasis therapy is recommended for patients found to have active bleeding, non-bleeding visible vessels, or adherent clots during colonoscopy. Non-colonoscopic interventions like radiographic tests or surgery may be considered for high-risk patients who cannot undergo colonoscopy.
Guideline for blood transfusion in newborn (NNF)mandar haval
This document provides guidelines for blood transfusion in newborns. It discusses pre-transfusion testing including donor selection, blood typing, and leucodepletion. It recommends irradiated and CMV-negative blood for high-risk newborns. Indications for packed red blood cells, platelets, fresh frozen plasma, and granulocytes are outlined. Transfusion volumes and rates are specified. Complications of blood transfusion like infections and immunologic reactions are also mentioned.
This document provides information about blood component therapy including red blood cells and platelets. It discusses the components of red blood cells and platelets, their indications for transfusion, and their expected therapeutic effects. Emergency guidelines for transfusing uncrossmatched red blood cells are also outlined. Special considerations for pediatric red blood cell transfusions include choosing between divided units or aliquots depending on transfusion volume needed. Indications for platelet transfusions include preventing bleeding due to low platelet counts from various causes or during procedures. Expected platelet count increments from different doses are also presented.
blood transfusion in neonates (British society of hematology)Souhila Bait
Blood transfusion in neonates carries risks and should only be done when benefits outweigh risks. Special considerations for neonates include their small size, immature immune systems, and unique hemoglobin and erythropoiesis characteristics. Clinical guidelines can help standardize best practices to improve outcomes. Strategies to reduce transfusions include delayed cord clamping and restrictive blood sampling. Proper blood component specification, testing, and product selection are crucial to ensure safety.
The document discusses blood components and blood transfusion. It describes the main components of blood including red blood cells, platelets, and white blood cells. It then covers the principles and indications for blood transfusion, including improving oxygen carrying capacity and treating blood loss or low hemoglobin. Complications of transfusion are also mentioned.
This document provides guidelines for blood transfusion, including:
1. It discusses the selection and preparation of blood products such as whole blood, platelet concentrates, fresh frozen plasma, and packed red blood cells. Proper donor requirements, collection procedures, and storage conditions are outlined.
2. Indications, dosing, and expected responses to transfusions of various blood components are covered. Red blood cell and platelet transfusion thresholds and dosing are provided.
3. Safety procedures for blood typing, cross-matching, and transfusion monitoring are described. Special considerations for patients with conditions like autoimmune hemolytic anemia that could cause transfusion reactions are highlighted.
4. Two case illustrations demonstrate the
The document discusses the management of upper gastrointestinal bleeding (UGIB) in the emergency room. It recommends initial resuscitation including IV access and fluid resuscitation. Patients should be risk stratified using scoring systems like Rockall or Blatchford to determine need for endoscopy. Early endoscopy within 24 hours is recommended to identify risk level and manage high risk lesions. Post-endoscopy, high-dose PPIs should be given and H. pylori testing and treatment initiated if positive to prevent rebleeding.
This guideline from the Royal College of Obstetricians and Gynaecologists and the British Society for Gynaecological Endoscopy provides recommendations for the management of endometrial hyperplasia. It discusses risk factors, classification, diagnostic methods, and treatment approaches for both hyperplasia without atypia and atypical hyperplasia. Surgical and medical management options are presented, along with recommendations for treatment duration and follow-up.
Management Dilemmas in Acute Pulmonary Embolism Gamal Agmy
The document discusses 14 clinical dilemmas in the management of acute pulmonary embolism (PE) that were identified by physicians with interests in PE. For each dilemma, the current evidence and guidelines are reviewed and a practical approach is suggested. Some examples of the dilemmas addressed include differentiating between acute and chronic PE, determining which intermediate-risk PE patients should receive thrombolysis, and managing pregnant patients with significant PE.
This document discusses the different blood components available for clinical use and their indications. It defines the four basic blood components as whole blood, red blood cells, plasma, and platelet concentrates. It describes the contents and storage requirements of each component. It provides an overview of appropriate indications for transfusing red blood cells, fresh frozen plasma, cryoprecipitate, and platelet concentrates. It also discusses principles of patient blood management to minimize transfusion requirements.
The document provides guidelines for the prevention and management of postpartum hemorrhage (PPH). It defines PPH and notes that major PPH should prompt emergency measures. Active management of the third stage of labor, including prophylactic oxytocics, reduces the risk of PPH by about 60%. Risk factors for PPH can be identified antenatally, and care plans should account for such risks. Oxytocin is recommended for preventing PPH in vaginal and cesarean deliveries, though other options exist. Special precautions should be taken for women with placenta accreta/percreta.
1. The document discusses abnormal uterine bleeding (AUB) and provides classifications and management guidelines.
2. It describes different types of abnormal bleeding patterns and classifications including the FIGO and PALM-COEIN systems.
3. Evaluation and treatment recommendations are provided for various causes of AUB including polyps, adenomyosis, leiomyomas, endometrial hyperplasia/cancer, and coagulopathies.
Antepartum hemorrhage (APH) refers to bleeding after 20 weeks of pregnancy. Causes include placenta previa, placental abruption, and cervical issues. Anesthetic considerations for delivery include preparing for potential hemorrhage, choosing regional or general anesthesia depending on the urgency and maternal status, and strategies to minimize blood loss such as uterotonics. Complications of massive hemorrhage like coagulopathy and Sheehan's syndrome also require management. The goal is to anticipate blood loss and be prepared for potential life-threatening issues from APH.
This document summarizes neonatal and pediatric transfusion guidelines. It discusses indications for neonatal red cell exchange transfusion including treatment of hyperbilirubinemia and hemolytic disease of the newborn. It provides details on component selection, preparation, and administration for neonatal transfusions including red cells, platelets, fresh frozen plasma and cryoprecipitate. Thresholds for neonatal platelet and red cell transfusions are outlined. Considerations for transfusion of older infants and children are also reviewed.
Massive transfusion protocols aim to standardize the resuscitation of patients experiencing severe bleeding through the early administration of blood products. The key aspects of such protocols discussed in the document include:
- Definitions of massive transfusion as the replacement of over 50% of total blood volume within 3-4 hours or transfusion of over 10 units of packed red blood cells within 24 hours.
- Common clinical conditions requiring massive transfusion include severe trauma, ruptured aortic aneurysms, and obstetric or surgical complications.
- Current concepts favor permissive hypotension and minimal crystalloid resuscitation to control bleeding before aggressively restoring blood pressure and volume.
- Blood products administered according to protocols include packed red blood
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
Assessment and Planning in Educational technology.pptxKavitha Krishnan
In an education system, it is understood that assessment is only for the students, but on the other hand, the Assessment of teachers is also an important aspect of the education system that ensures teachers are providing high-quality instruction to students. The assessment process can be used to provide feedback and support for professional development, to inform decisions about teacher retention or promotion, or to evaluate teacher effectiveness for accountability purposes.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Physiology and chemistry of skin and pigmentation, hairs, scalp, lips and nail, Cleansing cream, Lotions, Face powders, Face packs, Lipsticks, Bath products, soaps and baby product,
Preparation and standardization of the following : Tonic, Bleaches, Dentifrices and Mouth washes & Tooth Pastes, Cosmetics for Nails.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.