What is Blood Management

1
What is Blood Management?

• A Patient Guide

2
Blood Management Involves

• Ensuring that every decision to transfuse blood
  is made with careful attention to the risks and
  benefits for each individual
• Informing patients and encouraging their
  participation in transfusion decisions
• Using state-of-the-art techniques to avoid the
  need for blood transfusion
• Minimizing unnecessary sources of blood loss
• Advance planning to build blood counts
  before procedures

3
Why Blood Management?

• Periodic blood shortages
• The rising cost of blood products
• Common sense Why run even a small risk of side
  effects if theyre avoidable?
• Availability of effective alternatives
• Increasing public interest in alternatives to
  banked blood

4
Blood Supply Shortages

• Predictable drops in donations during
• Busy summer vacation months
• Holiday seasons / 3-day weekends
• Bad weather or disaster situations
• Fewer eligible donors as pre-donation questions
  are added to predict donor risk for rare
  infections
• Changing perception of social
  responsibility among new generations
  of donors

5
The Rising Cost of Blood

• Health care costs are increasing faster than any
  other sector of our economy Americans expect the
  very highest standard of care
• As new threats to the blood supply are
  discovered, more and more tests are required on
  every unit of blood
• Enhanced quality control in blood collection
  ensures the safest possible products, but
  at increased cost

6
Hospital Economics

• Blood costs include more than just the cost of
  collecting products
• Hospitals pay to test patients before
  transfusion, store blood and dispense it from the
  blood bank, and give it to patients, with many
  safety checks at every step
• Side effects, if they occur, add costs for
  treatment and longer hospital stays
• Avoiding unneeded transfusions saves
  all these costs and prevents unnecessary
  side effects

7
Transfusion Side Effects

• Known, and emerging, infections transmitted by
  blood (bacteria, viruses, unusual things like
  malaria)
• Allergic and febrile (fever chills) reactions
• Antibody reactions (when the immune system is
  activated and destroys transfused cells or
  attacks our own body)
• Human error transfusing the wrong
  blood to the wrong person

8
Blood Management Strategies

• Investigate a low red blood cell count (anemia)
  and correct it with iron, vitamins or growth
  factors
• Minimize blood loss using state-of-the art
  surgical techniques and medications
• Use your own blood drawn weeks before, or even
  during surgery, to avoid the need for blood from
  others
• Restrict blood drawn for lab tests
• Consider lower red blood cell
• counts for transfusion
• Discuss the risks and benefits with your
  physicians

9
Hospital-Based Blood Management Programs
Philosophy

• Every drop of
• blood counts

10
Hospital-Based Blood Management Programs
Integration

• Physician leaders
• Core blood management team
• Hospital-wide blood conservation policy and
  protocols
• Education for physicians and staff
• Community education

11

• Blood Management Programs
• Hospital-Based Blood Management Programs are more
  successful when everyone works together
• Administration
• Physicians
• Nurses
• Patients

12
Hospital-Based Blood Management Programs
Before the operation
After the operation
During the operation
A TOTAL APPROACH TO PATIENT CARE
13
Patient Blood Management
Coordination and Attentionto Detail is Important

• Before surgery
• Build up your blood counts
• During surgery
• Lose less blood
• After surgery
• Continue blood-building treatments
• Limit blood sampling

14
Summary

• Blood management options should be a part of
  making good health care choices
• Building your blood counts up before surgery may
  help you to avoid a blood transfusion
• Safe effective alternatives to blood
  transfusion are available
• Sometimes, several blood management options
  can used at the same time to avoid a
  blood transfusion
• No single approach (drug, device, technique)
  is effective for everyone

15
What Can I Do?

• Choose a doctor who will work with you
• Know what your blood counts are
• Ask your doctor what options may be available to
  avoid a transfusion
• Have your doctor explain the risks and benefits
  of your decision so you can make a choice thats
  good for you
• Check the web-site at www.sabm.org
  for a list of hospitals with blood
  management programs in your area