Patient Blood Management

To support our Vision of a Total Healing Environment, Dignity Health Yavapai Regional Medical Center (YRMC) wants you to be informed about your healthcare. We also want to partner with you to help you make decisions about the care you receive. This includes presenting you with treatment options and helping you understand the availability of alternatives to blood transfusions.

Blood transfusions have been an important life-saving therapy for many years. What is frequently overlooked, however, is the fact that a therapy deemed suitable yesterday may no longer be the first choice today.

While blood transfusions continue to be important to healthcare delivery, growing evidence shows that patients who do not receive a transfusion have lower infection rates as well as fewer kidney, lung and heart complications. This is the science behind Patient Blood Management (PBM) and the reason why YRMC has made the commitment to adopt comprehensive PBM protocols for patients who prefer to not receive a transfusion.

Take a look at strategies YRMC uses to minimize blood loss and enhance blood protection through its PBM program.

  • Preoperative Strategies: Appropriate Diagnostic Testing for all Patients
    • Our goal is to detect, prevent and respond to hemorrhage and anemia at the outset of treatment. Anemia is a manifestation of underlying disease and should be treated preoperatively, if possible.
    • Minimize blood draw volumes
    • Combine tests to reduce the frequency of blood draws
    • Monitor and manage routine orders for blood tests

     

  • Preoperative Blood Management Strategies: Optimize Red Blood Cell Mass to Prevent Anemia
    • The following medications, agents and management strategies are considered for anemic patients:
    • Iron therapy
    • Judicious use of Erythropoiesis Stimulating Agents (ESAs)
    • Vitamins B6, B12, K and Folic Acid
    • Nutritional support
    • Manage medications that affect coagulation
    • Consider delaying surgery until better blood scores are achieved

     

  • Intraoperative Blood Management Strategies: Close Surveillance for Blood Loss and Prompt Arrest of Bleeding
    • Perioperative use of acute normovolemic hemodilution—removal of a calculated amount of blood prior to surgery, replace with non-blood expanders with reinfusion of red cells back to patient
    • Intraoperative blood salvage—the process of collecting the patient’s blood lost during surgery then washing, filtering and reinfusing the red blood cells back to the patient
    • Judicious volume resuscitation such as by crystalloids and colloids
    • Hemostatic agents—oral, parenteral and topical
    • Meticulous surgical techniques

     

  • Postoperative Blood Management Strategies: Continue to Follow PBM Protocols to Aid Speedy Recovery
    • Minimize blood draw frequency and volume
    • Postoperative blood salvage—the process of collecting the patient’s blood lost after surgery and washing, filtering and reinfusion of red blood cells back to the patient
    • Continued iron therapy
    • Judicious use of Erythropoiesis Stimulating Agents (ESAs)
    • Nutritional support
    • Low tolerance for re-exploration if post-operative bleeding is excessive

     

View PBM Video!