Bloodless Medicine and Surgery: A Review of Practice and Consideration of Jehova Witnesses

Blood transfusion plays important role in medical and surgical practice and has been employed in varying medical and surgical procedures. An increasing amount of literature concerning blood conservation, restrictive transfusion strategies, pharmacological manipulation of the haemostatic and fibrinolytic systems, minimal invasive surgery, local haemostatic agents and guidelines for blood transfusion, is being published each year. This review aims to summaries the key concepts of bloodless medicine and surgery, offer a practical guide on how to approach such cases and outline currently available approaches to manage anemia or bleeding in patients. The standard practice is to keep vigilance to the possibility of reactionary or secondary haemorrhage. Continued bleeding is aggressively managed by postoperative blood salvage, or surgical intervention to stop haemorrhage. A multidisciplinary effort therefore has to be made through the entire chain, from the outpatient clinic through discharge from the hospital, with the utmost exertion of all team members in which surgeons play a key role and the medical laboratory scientist in the adaptation of bloodless surgery program.