Policies for dealing with the blood needs of massively bleeding patients with little chance of survival at a time of severe blood shortage
A transfusion medicine physician at an academic medical center in Irvine comments that they have struggled in the past with the question of how to decide that enough blood has been given to a trauma/surgical patient with no chance of survival (as perhaps stated by the senior anesthesiologist), and the surgical team insists in using blood until the last drop or until the patient finally dies. The current shortage has again brought this issue to the forefront and they are putting together a team of surgeons, anesthesiologists, ethicists and blood bankers to see if there is a way to address this very difficult moral question. Is there any institution that has already developed a policy dealing with this matter?
The editor suggests that the following discussions may be germane to the question raised by this physician:
The following response has been received.
ADDENDA Feb. 10, 2004
- A colleague from Texas says that she really hopes to read that someone, somewhere has a policy to address maximum blood usage in massive transfusion. She believes that if at least one facility sets some limits, albeit a very, very touchy subject, others may follow. She believes that transfusion services should be fearful of having no blood for an emergency because all of their stock has been used up for a single massively bleeding patient (with the best of intentions). Her hospital has only 300 beds, thus they do not have a large blood stock to begin with. They would like to set a policy, if only they could get a reference.
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