Clinical Use of Blood in Medicine, Obstetrics, Paediatrics, Surgery & Anaesthesia, Trauma & Burns (The)

Blood transfusion is an essential part of modern health care. Used correctly, it can be a life-saving intervention. Inappropriate use can endanger life because of the potential risk of acute or delayed complications, including the transmission of infectious agents, such as HIV, hepatitis viruses, syphilis, malaria and Chagas disease. The decision to transfuse blood or blood products should therefore always be based on a careful assessment of clinical and laboratory indications that transfusion is necessary to save life or prevent significant morbidity. The Clinical Use of Blood is an accessibl. Preface......Page 6 Acknowledgements......Page 8 Introduction......Page 10 Part 1 Principles, products and procedures......Page 14 1 The appropriate use of blood and blood products......Page 15 1.1 Appropriate and inappropriate transfusion......Page 17 1.2 Blood safety......Page 18 1.3 Prerequisites for the appropriate clinical use of blood......Page 24 1.4 Principles of clinical transfusion practice......Page 26 2 Blood, oxygen and the circulation......Page 28 2.1 Body fluids and compartments......Page 30 2.2 Blood......Page 32 2.3 Oxygen supply to the body......Page 36 3 Anaemia......Page 46 3.1 Definitions......Page 48 3.2 Measuring haemoglobin concentration and haematocrit......Page 50 3.3 Clinically important anaemia......Page 51 3.4 Interpreting haemoglobin values......Page 52 3.5 Causes of anaemia......Page 54 3.6 Adaptation to anaemia......Page 55 3.7 Anaemia due to acute blood loss......Page 56 3.8 Anaemia due to chronic blood loss......Page 60 3.9 Chronic anaemia due to other causes......Page 61 3.10 Principles of the treatment of anaemia......Page 62 3.11 Principles of the prevention of anaemia......Page 63 4 Replacement fluids......Page 65 4.1 Definitions......Page 67 4.3 Intravenous replacement fluids......Page 68 4.4 Other routes of administration of fluids......Page 72 4.5 Replacement fluids: characteristics......Page 73 5 Blood products......Page 80 5.2 Whole blood......Page 82 5.3 Blood components......Page 83 5.5 Plasma derivative production......Page 89 5.6 Blood products: characteristics......Page 90 6.7 Monitoring the transfused patient......Page 130 6.8 Specialized procedures......Page 132 7 Adverse effects of transfusion......Page 134 7.1 Transfusion reactions......Page 136 7.2 Initial management and investigation......Page 137 7.3 Acute transfusion reactions......Page 142 7.4 Delayed complications of transfusion: transfusion-transmitted infections......Page 148 7.5 Other delayed complications of transfusion......Page 154 7.6 Massive or large volume blood transfusions......Page 157 Part 2 Transfusion in clinical practice......Page 161 8 Clinical decisions on transfusion......Page 162 8.2 Confirming the need for transfusion......Page 163 9 General medicine......Page 166 9.1 Anaemia......Page 168 9.2 Deficiency of haematinics......Page 179 9.3 Haemolytic anaemias......Page 182 9.4 Malaria......Page 184 9.5 HIV/AIDS......Page 188 9.6 Glucose-6-phosphate dehydrogenase (G6PD) deficiency......Page 190 9.7 Bone marrow failure......Page 191 9.8 Genetic disorders of haemoglobin......Page 195 9.9 Bleeding disorders and transfusion......Page 205 9.10 Congenital bleeding and clotting disorders......Page 208 9.11 Acquired bleeding and clotting disorders......Page 211 10 Obstetrics......Page 216 10.1 Physiological & haematological changes during pregnancy......Page 218 10.2 Chronic anaemia in pregnancy......Page 220 10.3 Major obstetric haemorrhage......Page 226 10.4 Haemolytic disease of the newborn (HDN)......Page 232 11 Paediatrics & neonatology......Page 235 11.1 Paediatric anaemia......Page 237 11.2 The management of paediatric anaemia......Page 241 11.3 Paediatric transfusion in special clinical situations......Page 248 11.4 Bleeding and clotting disorders......Page 250 11.5 Thrombocytopenia......Page 251 11.6 Neonatal transfusion......Page 252 12 Surgery & anaesthesia......Page 262 12.1 Patient selection and preparation......Page 264 12.2 Techniques to reduce operative blood loss......Page 269 12.3 Fluid replacement and transfusion......Page 271 12.4 Autologous blood transfusion......Page 280 12.5 Care in the postoperative period......Page 283 13 Trauma & acute surgery......Page 286 13.2 Initial assessment and resuscitation......Page 288 13.3 Reassessment......Page 295 13.5 Other causes of hypovolaemia......Page 298 13.6 The management of paediatric patients......Page 299 14 Burns......Page 303 14.1 The management of burns patients......Page 305 14.2 Assessing the severity of burn......Page 306 14.3 Fluid resuscitation in burns patients......Page 309 14.4 Continuing care of burns patients......Page 313 14.5 Burns prevention......Page 315 Part 3 The appropriate use of blood: putting it into practice......Page 316 15 Making it happen: what can I do?......Page 317 15.1 Where do I start?......Page 319 15.2 Developing a plan of action......Page 323 15.3 Hospital transfusion committee......Page 325 15.4 Guidelines on the clinical use of blood......Page 326 15.5 Education and training on the clinical use of blood......Page 329 Glossary......Page 331 Index......Page 337 Attempts To Provide An Accessible Learning Tool That Will Assist Prescribers Of Blood To Make Appropriate Clinical Descisions On Transfusion And Contribute To Wider Efforts To Minimize The Unnecessary Use Of Blod And Blood Products. [module Of Learning]. - 337 S. ; 30 Cm + 1 Beil. Handbook. - 219 S. ; 21 Cm. Project Director: Jean C. Emmanuel--p. [ix]. Includes Index. Summarizes the information provided in the module, The Clinical Use of Blood, and has been produced for quick reference by clinicians who need to make urgent decisions on transfusion