- Jehovah's witness
- Acceptability
- Unacceptable
- Whole blood
- Packed red cells
- Plasma
- Autologous pre-donation
- Acceptable
- CPB
- Dialysis
- Acute hypervolameic haemodilution
- Epo
- Recombinant factor VII
- May be acceptable
- Platelets
- Clotting factors
- Albumin
- Immunoglobulins
- Epidural blood patch
- Cell saver
- Other considerations
- May have advanced directive
- Special consent form
- May have discussion with elders
- In an emergency give blood, unless there is documentary evidence
- For under 16s - discuss with parents and child but most understand that a doctor will not allow a patient under 16 to die.
- Perioperative management
- Pre-op
- Planning is important
- Anaesthetist can refuse to do elective case
- Set out rules of management
- Optimise pre-op status
- Iron supplementation
- Erythropoietin
- IV iron
- Stop anticoagulants
- Intra-op
- Surgical
- Laparascopic
- Biological haemostats
- Diathermy
- Senior surgeon
- Anaesthetic
- Avoid venous congestion
- Avoid high intrathoracic pressures
- Warming
- Hypotensive anaesthesia
- Regional anaesthesia
- Cell saver?
- Drugs
- Tranexamic acid
- DDAVP
- Aprotinin
- Factors VIII, IX & VIIa are available
- Acute hypervolameic haemodilution
- ? Red cell substitutes under trial
- Post-op
- Good nutrition
- Monitor blood loss
- Possibly hyperbaric chamber
- CEACCP
Link:ceaccp.oxfordjournals.org/content/4/2/35.full.pdf