Bloodless Medicine Surgery

Committed to Choice

At Whittier Hospital Medical Center we are committed to providing our patients a range of services which are sensitive to their needs and desires in relation to blood products. We understand that many patients choose not to receive blood products under any conditions, and we respectfully accommodate this choice. Other patients would prefer not to have blood products administered, but will accept them under certain circumstances.

Our Bloodless Medicine and Surgery Program is affiliated with a multi-specialty panel of physicians who are dedicated to upholding patient's preferences regarding blood, and experienced in providing a variety of medical and surgical services without its use. Whatever your feelings are regarding blood transfusions, the Bloodless Medicine and Surgery team at Whittier Hospital will respect your wishes.

Program Definition

A Blood Transfusion-Free Program involves organization and management of hospital processes with skilled medical/surgical strategies. It is sometimes referred to as Blood Transfusion-Free or Bloodless Medicine and Surgery and involves medical and surgical procedures without blood transfusion.

Significant Advantages

For those patients who prefer health care services without blood transfusion, there are numerous advantages in seeking services at a facility that has a Bloodless Medicine and Surgery Program. Generally, these include:

• Personal support from a Program Coordinator
• Greater level of transfusion-free expertise
• Established nonblood clinical strategies implemented in an expeditious way
• Hospital wide, personalized patient cooperation and support
• Specific, detailed patient identification to help insure patients' directives are followed regarding nonblood management
• Networking with other Bloodless programs and physicians

Hospital support system:

• Administration
• Physician panel
• Hospital Leadership
• Nursing staff
• Coordinator
• Ancillary services

Services provided without blood transfusion:

• No whole blood, red cells, white cells, platelets or plasma
• Use of plasma proteins and products that may contain plasma proteins are individual patient decisions
• Services provided without patients pre-deposited blood
• Intraoperative and postoperative blood salvage customarily practiced when appropriate and acceptable to patient
• Equipment set up in continuous circuit with non-blood prime

Principles of Patient Core

• Good medicine and surgery applied in a progressive and focused environment
• Careful surgical procedures used to prevent blood loss (meticulous hemostasis)
• Strategies are employed to help minimize blood loss resulting from hemorrhage
• Smaller samples are used for blood tests (reducing Iatrogenic blood loss)
• Methods are employed to help maximize oxygen delivery to body cells
• Methods are employed to minimize oxygen consumption by body cells
• Pharmaceutical agents are used to improve blood count
• Valuable time is not wasted - health care providers avoid the "wait and watch" approach

Role of Patients

Prepares documentation such as Advanced Medical Directives

Becomes knowledgeable of issues requiring personal decisions

Makes decisions prior to development of health problems or emergencies, whenever possible

Explains directives clearly to:

• Physicians
• Nurses
• Admitting Department personnel
• Emergency room personnel
• Any others responsible for patient care
• Does not wait until there is a crisis/takes initiative
• Does not depend on paramedics to convey healthcare directives to hospital personnel
• Has a relative or friend accompany him/her to the hospital who is able to clearly and accurately convey the patient's personal directives, especially if an emergency or other major health crises is involved
• Contacts Transfusion-Free Coordinator, in advance, when anticipating need for physician or hospital services

Role of Physicians

• Is educated in principles of clinical strategies for managing patients without blood transfusion
• Comprehends and applies appropriate principles of nonblood medical management
• Ascertains patient's individual directives
• Respects Patients' Rights regarding informed choice/consent
• Explains to patient risks and benefits of avoiding blood transfusion
• Avoids pressuring patient in an attempt to change patient's mind
• Verifies that all members of medical and surgical teams understand patient's directives
• Willingly consults with other physicians experienced in nonblood medical management strategies
• Takes initiative during crises, avoiding the "wait and watch" posture
• Adjusts Physician Orders to help minimize blood draws, ordering pediatric or micro sampling for blood tests

Role of Program Coordinator

• Coordinates day-to-day program operations and responsibilities
• Provides direct patient support
• Assists with physician referrals
• Provides educational sessions
• Interfaces with other team members

Patient Coordinator Bloodless Medicine and Surgery Program

• No Blood stickers for chart and documents
• No Blood sign for posting above bed (if requested by patient)
• Release of liability forms
• Copies of patient's Advance Directives
• Notifies Bloodless Coordinator

Role of Nursing

• Checks face sheet to determine if patient is in the Transfusion-Free program
• Is supportive of patient
• Avoids attempting to influence patient with personal feelings regarding transfusion therapy
• Places Transfusion-Free special wrist band on patient
• After surgery or when patient is moved to another room, sees that identification items listed above are in place
• Assists with communication - making sure all personnel, including physicians, are aware that patient is in the transmission-free program

For more information on Bloodless Medicine, visit noblood.org

* Patients need to select a physician that is part of the Bloodless Medicine Program and a Health Plan affiliated with Whittier Hospital Medical Center.