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Managing Patients Who Refuse Blood Transfusion Therapy (Individual)

October 20, 2011 1:00 - 2:00 PM ET

Presented by: Aryeh Shander, MD

Chief of Anesthesiology, Critical Care Medicine & Hyperbaric Medicine
Englewood Hospital & Medical Center



Abstract:
Blood transfusion has long been an integral part of modern medicine. Despite lack of attempts at evaluating the value of transfusion as a therapeutic intervention, its use has rarely been questioned. When the first global epidemic of HIV struck, rather than undertaking a calculated risk benefit analysis, all efforts and resources went to improve the ?safety? of the product.
Not until the 1990?s did a systematic approach to treating patients for whom blood was not an option develop. While we think of primarily those of the Jehovah?s Witness faith as patients for whom blood is not an option, in fact, other patients may be in a similar position for an entirely different reason.
The lion?s share of civilian experience in care without blood is within the Witness community. Religious conviction is their reason for not accepting major blood components, regardless of the outcome. Not having the option or transfusions, some health care providers developed an approach to treat both hemostatic defects and even life threatening anemia with complete survival. This experience was quickly shared with all patients, thus reducing their exposure to banked blood while demonstrating equal or better outcomes than with transfusion. As both pharmaceuticals and devices improve with time, and newer agents are introduced to clinical practice, the chasm between patients accepting transfusion and those who decline it will narrow and close.
Objectives:
At the conclusion of this lecture, the participant will be able to:
1. Explain cultural or religious beliefs of patients that refuse blood products in their medical care
2. Describe the concept of ?minor blood fractions? and their role in the management of patients that refuse blood component therapy
3. Identify evidence based clinical strategies that have been implemented successfully in the management of patients that refuse the use of blood products
Goal:
The goal of this presentation is to identify evidence based clinical strategies that have been implemented successfully in the management of patients that refuse the use of blood products.
Teaching Strategy:
The teaching strategy will be didactic in the form of a PowerPoint presentation, followed by a question and answer period.
Thank you for taking time to participate.


Thank you for taking time to participate.