International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Public health

Here, I report two instances when we used direct whole blood transfusions with critically ill patients. One occurred during a winter blizzard when a delivery was complicated by a postpartum hemorrhage due to a retained placenta. She received fifteen liters of normal saline and Ringer’s lactate. The nurses in the community collected blood from her sister and aunt, both of whom had prenatal medical charts that documented their blood groups and most recent testing of HIV and Hepatitis B. Using 20cc syringes and 18 gauge needles and intravenous catheters, the nurses transfused 200 cc of whole blood to the patient.

In another community, an elderly man suffered upper gastrointestinal bleeding. He presented to his local health center with melena stool, multiple large bruises over his back and flanks, a systolic blood pressure of 70-80 mmHg, and a manually-measured hemoglobin of 80 g/L. He received several fluid boluses of normal saline and awaited transfer to Winnipeg. His transfer was delayed by fog and a low ceiling at the local airport for two days. We decided to transfuse whole blood from two of his daughters. The patient’s blood group and antigen status was checked through the referral center (he had suffered a previous GI bleed in the past). Using 18 gauge IV catheters and 10 cc syringes flushed with 1 cc of a 1000 unit/cc heparin solution, we transfused 10 cc of whole blood at a time, discarding and replacing the syringes after about five uses, in order to minimize the chance of allowing the blood to clot. Each daughter donated 250 cc of whole blood, and the patient eventually was transferred to Winnipeg.

These cases highlight the need to develop a walk-in donor system in our region in order to avoid the need to revert to whole blood transfusions. We are lucky that the prevalence of HIV in the region remains extremely low and that we have easy access to complete prenatal charts in order to have determined the blood groups and hepatitis B and HIV status of the donors.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)