Treatment of blood loss focuses on two areas: stopping the bleeding and treating the effects of blood loss. The techniques used to stop bleeding depend on the cause and location of the bleeding. For external bleeding such as cuts and tears, direct pressure followed by bandaging or stitching can be used. For internal bleeding, surgery may be needed.
Treatment for the effects of blood loss depends on how much blood was lost; how quickly it was lost; and the person's medical conditions, medications, and religious beliefs. For mild blood loss, treatment with fluids and medications is often enough. For more severe blood loss, a blood transfusion or transfusion alternative is often needed. Some groups, such as Jehovah's Witnesses, will not accept transfusions for religious reasons.
Before the transfusion, the recipient (the person getting the transfusion) has their blood tested. Blood and blood products from a compatible donor (matched according to blood type and other factors) are given through a vein by injection. Blood transfusions usually involve giving the blood components (such as red blood cells or platelets) that a person is lacking.
Like any medical procedure, a blood transfusion has risks. Blood transfusion risks include:
- transfusion reactions: If donor blood is not properly matched to the blood type of the recipient, or if blood is given to the wrong person by mistake, severe illness may result, including hemolysis (breakdown of red blood cells), kidney damage, and even death. The risk of incompatible blood type transfusion is about 1 in 40,000.
- infectious disease: Even though the blood supply is thoroughly screened, there is still a small risk of getting a viral (including HIV, hepatitis, and West Nile virus), bacterial, or parasitic infection from a blood transfusion. The risk of contracting HIV from a blood transfusion is less than 1 in 4,000,000. The risk of getting hepatitis C is less than 1 in 2,800,000.
- allergic reactions: Allergic reactions to the transfused blood may be mild and easily treated, or severe and potentially leading to death. The risk of a serious allergic reaction is about 1 in 40,000.
When receiving health care, a person must be informed and agree to a treatment before treatment can be given. Since all medical therapy involves some degree of risk, patients make decisions about their treatment after weighing the risks and benefits of their options. This is called informed consent or informed choice. Any "competent" patient (a person who has the mental capacity to make their own treatment decisions, including an understanding of what may happen if they do not accept the suggested treatment) may refuse a treatment a doctor recommends, including blood transfusion.
Blood shortages and increased awareness of the risks associated with blood transfusions have spawned much research over the last decade into alternatives to blood transfusions. Today, there are a number of alternatives to blood transfusions. Blood transfusions can be minimized or avoided by using appropriate combinations of medications, medical devices, and surgical techniques. Many hospitals around the world now have blood conservation or bloodless medicine and surgery programs.
Medications can be used to stimulate the body to produce more blood cells. Erythropoietin is used to increase the body's production of red blood cells. G-CSF (granulocyte colony stimulating factor) and GM-CSF (granulocyte macrophage colony stimulating factor) are used to increase white blood cells. Other medications can be used to reduce bleeding during or after surgery or sudden blood loss. Special fluids such as pentastarch, saline, or Ringer's lactate can be used to temporarily replace the lost blood volume.
Devices such as blood salvage ("cell saver") machines can help reduce blood loss during surgery by collecting blood lost during surgery, processing it, and returning it to the patient. Specialized scalpels can cut through tissue and stop bleeding at the same time (by using heat, electric current, or ultrasonic vibration).
Surgical techniques and pre-surgery planning can also reduce blood loss. Large surgeries may be divided into several small ones, and new techniques such as laparoscopy reduce the need for large incisions. In pre-surgery planning, medications that increase the risk of bleeding are stopped or reduced before surgery, and other medications are taken to build up the body's reserve of blood cells. Some people choose to donate and store their own blood before an operation. In other cases, a technique called hypotensive anesthesia can be used to reduce surgical bleeding.
Not all of these transfusion alternatives will be available or appropriate for everyone. Like transfusions, transfusion alternatives also have risks. The risks and benefits of any treatment option will vary for each individual person. Before any treatment is chosen, it is important you and you doctor to review the options carefully.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Blood-Loss-Transfusions-and-Transfusion-Alternatives
