All blood counts : a manual for blood conservation and patient blood management / edited by Dafydd Thomas, John Thompson, Biddy Ridler.

Includes bibliographical references and index.

Print version record.

All Blood Counts: A manual for blood conservation and patient blood management -- Title Page -- Copyright -- Contents -- Contributors -- Foreword -- Chapter 1: Historical perspective -- The provision of blood for transfusion -- Introduction -- Prior to the end of the First World War -- After the First World War -- Blood grouping -- Pre-transfusion matching -- Blood donation safety -- Conclusions -- Checklist summary -- References -- Chapter 2: Transfusion transmitted infections -- Background -- What makes a microbial agent important to blood safety? -- Which agents are relevant to transfusion? -- Viruses -- Bacteria -- Parasites -- Prions -- Other 'emerging' infections -- Residual risk -- Conclusions -- Checklist summary -- References -- Further reading -- Chapter 3: Changing demographics -- projected impact on blood supplies/Blood Stock Management Scheme (BSMS) -- Background -- Evidence -- How much blood is there? -- How much blood do we need? -- Where does blood go? -- How can we influence blood usage and wastage? -- Inventory management by blood services -- Inventory management by hospitals -- Conclusions -- Checklist summary -- References -- Chapter 4: What patients and the public need to know about blood conservation -- and why they need an advocate -- Background -- Evidence -- How to do it -- Involve people before they become patients -- Need to know basis -- Patient advocacy -- Research -- Conclusions -- Checklist summary -- References -- Chapter 5: Haemovigilance in 2020? -- Background -- Observations from the UK haemovigilance system (Serious Hazards of Transfusion -- SHOT) -- Joint UK haemovigilance -- Patient safety -- The triangle of care and correct patient ID -- Acute transfusion reactions -- Acute reactions -- Allergic reactions -- Anti-D immunoglobulin (anti-D Ig) incidents -- Conclusions -- Checklist summary -- References.

Chapter 6: Patient safety -- Background -- How to do it -- How to prevent errors -- Centralised transfusion databases enhance patient safety -- Supporting and educating the prescriber when deciding if a patient needs to be transfused -- Conclusions -- Checklist summary -- References -- Chapter 7: NICE guidance and blood management -- Background -- A brief history of NICE -- Technology appraisals -- Clinical guidelines -- Interventional procedures -- Medical technologies -- NICE guideline on the assessment and management of blood transfusion -- Conclusions -- Acknowledgement -- Checklist summary -- References -- Chapter 8 Consent for blood transfusion in adults -- Background -- Evidence (best practice) -- Who can obtain consent for transfusion? -- Patient capacity to consent -- Patient refusal of consent -- Advanced decisions (or directives) -- The provision of information -- How much information to give? -- Has the patient understood the information I have given? -- How to do it -- Patients where a transfusion has been determined clinically necessary as a 'one-off' procedure -- Patients requiring long-term multiple transfusion episodes over an extended period of time (e.g. a patient with thalassaemia) -- Patients where it is thought that a transfusion may be required as part of a procedure, e.g. during surgery, but is not definite at the time of pre-procedure consent -- Emergency situations where it is not possible to consent the patient pre-transfusion -- Conclusions -- Checklist summary -- References -- Chapter 9: Patient consent in children -- Background -- Best interests -- Competence -- Background to competence in children -- Age, childhood and the threshold of adulthood -- Parental responsibility -- Consent between the ages of 16 and 18 -- Consent in children under 16 -- Refusal of treatment.

Clinical context of consent for blood transfusion in children -- Neonates and blood transfusions -- Emergencies and the incapacitated patient -- Situations where blood transfusions may be refused -- Documenting consent -- Practical guidance and information -- Conclusions -- Checklist summary -- References -- Chapter 10: Using clinical audit to improve transfusion practice -- Background -- A. Decide on a topic for audit -- High risk -- High cost -- High volume -- Local interest -- B. Agree the clinical behaviours to be audited, based on evidence-based guidance where possible -- Standards -- C to G. Agree what data should be collected/fed back to appropriate people -- Making a difference -- H. Allow some time for the information to be absorbed -- Clinical audit and clinical governance -- Conclusions -- Checklist summary -- References -- Chapter 11: Who needs transfusion? -- Background -- What do red cells do? -- Why do we transfuse red cells? -- Acute blood loss (Table 2) -- Recoverable anaemia in a haemodynamically stable patient (postoperative and other anaemias in patients without bone marrow failure) (Table 3) -- Bone marrow failure -- Thalassaemia -- Exchange transfusion -- Radiotherapy -- Risks of blood transfusion -- Conclusions -- Checklist summary -- References -- Chapter 12: Blood stock management from a laboratory perspective -- Background -- Determining stock levels -- Ordering blood products -- Rotating of blood stocks -- Issuing of blood products -- Returning of allocated units to stock -- Audit -- Specific considerations -- O negative red cells -- Frozen components -- Wastage of products -- Conclusions -- Checklist summary -- References -- Chapter 13: Prehabilitation -- Background -- Pre-operative anaemia -- Maintaining tissue oxygen delivery -- Nutrition and physical training -- Defining pre-operative anaemia.

Hepcidin and functional iron deficiency -- Diagnosis of anaemia and iron deficiency -- Pre-operative management of anaemia -- Minimisation of bleeding risk -- Conclusions -- Checklist summary -- References -- Further reading -- Chapter 14: Intra-operative cell salvage -- Background -- Evidence -- Vascular surgery -- Cardiothoracic surgery -- Orthopaedics -- Obstetrics and gynaecology -- Urology -- Other areas -- Adverse events -- ICS and tranexamic acid (TXA) -- How to do it -- Conclusions -- Checklist summary -- References -- Chapter 15: Surgical methods to prevent blood loss -- Background -- General approaches -- Reducing blood pressure -- Normothermia -- Interventional radiology -- Minimally invasive surgery and robotics -- Cell salvage -- Surgical instruments -- Lasers -- Ultrasound and water jet dissectors -- Topical haemostatic agents -- Conclusions -- Checklist summary -- References -- Chapter 16: Anaesthetic methods to minimise blood loss -- Background -- How to do it -- Patient positioning -- Tourniquets -- Vasoconstrictors -- Surgical technique -- Thermoregulation -- Balanced anaesthesia -- Permissive hypotension -- Acute normovolaemic haemodilution -- Conclusions -- Checklist summary -- References -- Chapter 17: Pharmacological methods for minimising blood loss -- Background -- Introduction -- Pharmacology of tranexamic acid (TXA) -- The efficacy of tranexamic acid in reducing traumatic bleeding -- Efficacy of tranexamic acid in reducing surgical bleeding -- Efficacy of tranexamic acid in postpartum haemorrhage -- Topical use of tranexamic acid -- Other areas where tranexamic acid is being trialled -- Dose of tranexamic acid -- Thrombotic risk -- Conclusions -- Checklist summary -- References -- Chapter 18: Postoperative blood salvage -- Background -- Evidence -- Efficacy of postoperative cell salvage -- Safety of unwashed blood.

How to perform postoperative blood salvage -- Devices -- Device selection -- Contraindications and precautions -- Actions to be taken -- Implications for everyday clinical practice -- Recipe for success -- Conclusions -- Checklist summary -- References -- Chapter 19: Haemostasis and sealing -- the continuum concept -- Background -- Relevance to blood conservation -- Haemostats -- an introduction -- Types of haemostats in clinical practice -- The importance of haemostats and blood transfusion -- Fibrin sealants -- an introduction -- Fibrin sealants -- applicability to clinical practice -- Safety -- Efficacy -- Health economic outcomes -- Synthetic sealants -- introduction and types -- Anti-adhesion -- Sealants in blood conservation -- Portfolio approach to surgical challenges -- Conclusions -- Checklist summary -- References -- Chapter 20: Transfusion triggers for blood and blood products: the evidence -- Background -- Evidence -- Allogeneic red blood cell transfusion -- Fresh frozen plasma, platelets, cryoprecipitate and fibrinogen concentrate -- Risks associated with blood and blood products -- How to do it -- What is the clinical setting? -- Is there a need to transfuse? -- Old blood or new blood? -- What about blood products? -- Practicalities -- Conclusions -- Checklist summary -- References -- Chapter 21: Trauma-induced coagulopathy -- Background -- Revision of the classical description of coagulopathy -- Drivers of trauma-induced coagulopathy (Figure 1) -- Mechanisms of acute traumatic coagulopathy -- Systemic anticoagulation via protein C activation -- Hyperfibrinolysis -- Fibrinogen depletion -- Endothelial activation -- Platelet dysfunction -- Early diagnosis of trauma-induced coagulopathy -- Laboratory coagulation screens -- Fibrinogen measurement -- Point of care -- viscoelastic haemostatic assays -- Clinical scoring systems.

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