Jehovah's Witnesses: A case that can happen to us [Part 3]
Tuesday, March 8, 2011
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In our country will undoubtedly be made unnecessarily large proportion of all blood transfusions. Excessive fear of medico-legal problems make the medical act "defensive" or "in anticipation of ..." indicate when the use of blood components (red cells, plasma, platelets, cryoprecipitate). A common mistake in stating transfusions based solely on laboratory tests and do not consider, as expected, the patient's symptoms.
blood containing red blood hemoglobin (Hb ), a protein that carries oxygen to all body tissues. The normal value of hemoglobin in adults could be 11 to 15 grams per deciliter. So having a Hb of 10 would suffer from mild anemia.
With Hb of 8 or less would face a severe anemia (severely affected the transport of oxygen to noble organs (brain, heart, liver, kidneys, etc.).. Few opinarÃan against a red cell transfusion to bring the Hb deficit. But blood transfusions may cause serious complications, forcing us to indicate only when strictly necessary, if the low value of Hb is accompanied by symptoms like tiredness, extreme pallor, angina, and others.
Several viruses, bacteria and parasites can be transmitted by blood, but often their presence in circulation is accompanied by signs of disease in infected individuals, which limits it is presented as a donor. However, some harmful microorganisms have a long incubation period, during which infected people show no symptoms but their blood is infectious- and can be transmitted by transfusion, such as the AIDS virus (HIV) and hepatitis B virus (HBV) and C (HCV). With
epidemiological studies have been able to identify patterns that are associated with increased risk of infection by HIV, HBV and HCV, thereby preventing asymptomatic carriers infected individuals to donate blood. Given that between the time of infection by these agents and the appearance of markers of infection in the human body tends to take some time-the so-called period of "window" - to report the situation to potential donors and conduct a interview careful before donation, reduce the amount of donations from infected people.
Usually, there is consensus that the altruistic volunteer donors who donate blood repeatedly are those that present less risk compared to those who give blood to replace blood provided by bank or monetary compensation.
Jehovah's Witnesses do not accept blood transfusions. Neither way around it. We do not believe to be a problem if it is elective surgery. There will be plenty of time for the patient arrives in the best conditions (erythropoietin, iron supplements) to the operating room.
The issue becomes tricky when it comes to emergency surgery. The patient or guardian (if child or mentally ill or if you are unconscious), expressed in writing his steadfast refusal to receive blood transfusion. But a serious complication occurs by "x" or "and" reasons unrelated to the work of the anesthesiologist. Not unlikely that arises around a close relative who blame his failure to attend to the judicial authorities to order this saving blood transfusion. And that charge could become lawsuit in court.
For the above, we think of capital importance establish a protocol for action in emergency surgery in Jehovah's Witness patients. So we will avoid many surprises.
not forget that there are former Jehovah's Witness willing to demand that the prime science over religion when deciding the therapy to save a life.
blood containing red blood hemoglobin (Hb ), a protein that carries oxygen to all body tissues. The normal value of hemoglobin in adults could be 11 to 15 grams per deciliter. So having a Hb of 10 would suffer from mild anemia.
With Hb of 8 or less would face a severe anemia (severely affected the transport of oxygen to noble organs (brain, heart, liver, kidneys, etc.).. Few opinarÃan against a red cell transfusion to bring the Hb deficit. But blood transfusions may cause serious complications, forcing us to indicate only when strictly necessary, if the low value of Hb is accompanied by symptoms like tiredness, extreme pallor, angina, and others.
Several viruses, bacteria and parasites can be transmitted by blood, but often their presence in circulation is accompanied by signs of disease in infected individuals, which limits it is presented as a donor. However, some harmful microorganisms have a long incubation period, during which infected people show no symptoms but their blood is infectious- and can be transmitted by transfusion, such as the AIDS virus (HIV) and hepatitis B virus (HBV) and C (HCV). With
epidemiological studies have been able to identify patterns that are associated with increased risk of infection by HIV, HBV and HCV, thereby preventing asymptomatic carriers infected individuals to donate blood. Given that between the time of infection by these agents and the appearance of markers of infection in the human body tends to take some time-the so-called period of "window" - to report the situation to potential donors and conduct a interview careful before donation, reduce the amount of donations from infected people.
Usually, there is consensus that the altruistic volunteer donors who donate blood repeatedly are those that present less risk compared to those who give blood to replace blood provided by bank or monetary compensation.
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The issue becomes tricky when it comes to emergency surgery. The patient or guardian (if child or mentally ill or if you are unconscious), expressed in writing his steadfast refusal to receive blood transfusion. But a serious complication occurs by "x" or "and" reasons unrelated to the work of the anesthesiologist. Not unlikely that arises around a close relative who blame his failure to attend to the judicial authorities to order this saving blood transfusion. And that charge could become lawsuit in court.
For the above, we think of capital importance establish a protocol for action in emergency surgery in Jehovah's Witness patients. So we will avoid many surprises.
not forget that there are former Jehovah's Witness willing to demand that the prime science over religion when deciding the therapy to save a life.
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