Blood Transfusions. By Hayley & Pete.

Blood Transfusions. Blood transfusion is the process of transferring blood or blood-based products from one person into the circulatory system of another. Blood transfusions can often be life-saving in some situations. For example if the patient has suffered a massive blood loss due to a severe accident a blood transfusion may be vital if the patient is going to survive. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood.

Blood Transfusion Procedure. Blood transfusions can be grouped into two main types depending on their source: 1) Homologous transfusions, or transfusions using the stored blood of others. These are often called Allogeneic instead of homologous. 2) Autologous transfusions, or transfusions using the patient's own stored blood. Donor units of blood must be kept refrigerated to prevent bacterial growth and to slow cellular metabolism. The transfusion must begin within 30 minutes after the unit has been taken out of controlled storage. Blood can only be administered intravenously. It therefore requires the insertion of a cannula of suitable caliber. Before the blood is administered, the personal details of the patient are matched with the blood to be transfused, to minimize risk of transfusion reactions. Clerical error is a significant source of transfusion reactions and attempts have been made to build redundancy into the matching process that takes place at the bedside. A unit (up to 500 ml) is typically administered over 4 hours. In patients at risk of congestive heart failure, many doctors administer a diuretic to prevent fluid overload, a condition called Transfusion Associated Circulatory Overload or TACO. Acetaminophen and/or an antihistamine such as diphenhydramine are sometimes given before the transfusion to prevent other types of transfusion reactions.

Jehovah’s Witnesses. Jehovah's Witnesses believe that the Bible prohibits ingesting blood, and that this includes the storage and transfusion of blood, this also includes cases of medical emergency. This belief was introduced in 1945, and has been elaborated ever since. Accordingly, the organization are holding 'Hospital Information Services' responsible for education and facilitation of bloodless surgery. This service also maintains 'Hospital Liaison Committees', whose function is to provide support to adherents. Although accepted by the majority of Jehovah's Witnesses, a minority does not wholly endorse this principle. Surprisingly different sides of the belief have drawn both praise and criticism from members of the medical and non- medical community.

Jehovah’s Witnesses Beliefs. Based on their interpretation of various biblical texts, such as Genesis 9:4, Leviticus 17:10, and Acts 15:29, Jehovah’s Witnesses believe: Blood is sacred to God. Blood means life in God's eyes. Blood must not be eaten or transfused. Blood leaving the body of a human or animal must be disposed of, except for autologous blood transfusions considered part of a “current therapy”. Blood was reserved for only one special use, the atonement for sins, which led up to Jesus' shed blood. When a Christian abstains from blood, they’re in effect expressing faith that only the shed blood of Jesus Christ can truly redeem them and save their life. Even in the case of an emergency, it is not permissible to sustain life with transfused blood. Conscientious violation of this doctrine is considered a serious offense, after which a member is subject to organized shunning.

Blood Transfusion Substitutes As of 2009, there are no widely utilized oxygen-carrying blood substitutes for humans; however, there are widely available non- blood volume expanders and other blood-saving techniques. These are helping doctors and surgeons avoid the risks of disease transmission and immune suppression, address the chronic blood donor shortage, and address the concerns of Jehovah's Witnesses and others who have religious objections to receiving transfused blood. A number of blood substitutes are currently in the clinical evaluation stage. Most attempts to find a suitable alternative to blood thus far have concentrated on cell-free hemoglobin solutions. Blood substitutes could make transfusions more readily available in emergency medicine and in pre-hospital EMS care. If successful, such a blood substitute could save many lives, particularly in trauma where massive blood loss results.

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