What is bloodless care?
It is an intensive program of medical care in which medical and surgical problems are treated without the use of blood.

Why would someone choose bloodless care?
There are a variety of reasons someone might refuse a blood transfusion.

The total avoidance of blood transfusions could be a matter of religious belief or personal conviction among some patients.  Others may wish to avoid the use of donor blood to minimize the risk of blood-borne infections and prevent immune system suppression.

How can you perform surgery without blood?
With careful planning and preparation, certain types of medication and iron supplements can be given for a few weeks prior to surgery to stimulate the production of more red blood cells.  During surgery, blood can be conserved by using meticulous technique and state-of-the-art surgical instruments to stop or prevent excessive bleeding.  In many cases, blood lost during a surgical procedure can be salvaged and recycled.

Is this a safe alternative?
In most cases, transfusions can be safely avoided.  Experts are finding that patients are able to tolerate and safely recover from much lower blood counts than previously thought. 

Is our country’s blood supply unsafe?
In the United States, donor blood is tested for several infectious diseases.  However, there are other infectious agents that are not screened. Furthermore, introducing donor blood into your system can suppress your body’s immune system and make infection more likely.

Will my insurance cover the cost of bloodless treatment?           Lakewood Regional Medical Center accepts many forms of insurance and we will gladly work with others to arrange for care on a case by case basis. 

What if I am in an accident and require emergency treatment or surgery?
Make sure you are taken to a facility with a bloodless care program like the Lakewood Regional Medical Center. If you can speak for yourself, tell the Emergency room personnel, admitting personnel, nurses etc. about your choice for transfusion-free care.  If you are at Lakewood Regional Medical Center (LRMC) the Program Coordinator will be alerted to your admission and will visit you to make sure your wishes are documented.

What if I cannot speak for myself in an emergency situation?
Tell your friends, relatives, co-workers… anyone who may be in a position to speak on your behalf.  Put your wishes in writing in the form of a Living Will or Advance Directive.  Make sure several people have a copy of this.  You may also choose to carry a card in an obvious location, for example attached to your driver’s license that clearly states your wishes.  The LRMC staff can help you create an advance directive if you do not have one. 

Will you provide bloodless treatment for my child?
Yes, with the consent of a legal guardian.  Physicians at the LRMC have agreed to explore and exhaust all non-blood alternatives in the treatment of children. However, California State Law requires physicians to administer blood transfusions to minors if the transfusion is judged necessary to prevent immediate death or loss of function of a major organ.

If I choose bloodless care, can I change my mind at a later date?
Yes, participation in the bloodless program is completely voluntary and you may withdraw at any time. 

Why should I choose the Lakewood Regional Medical Center?
Our patients are treated with a special, individualized level of care that is tailored to their specific medical needs.  Our Program Coordinator is available 24 hours a day, seven days a week to answer questions or assist patients.  LRMC has physicians that are committed to the provision of transfusion free care and represent a full range of medical and surgical disciplines.

How can I obtain more information?    Call (562) 529-5417 to speak with a coordinator.

WHAT IS TRANSFUSION-FREE MEDICINE?

Re-Thinking Conventional Wisdom -
With the advent of universal testing of all donor blood, the medical community embraced the idea that when in doubt, it was better to transfuse than not to transfuse.  Now, with a clearer understanding of anemia and its effects on the body, this conventional wisdom is being challenged. In fact, we know that with the use of pharmaceutical agents, intravenous fluids, along with improved diagnostic procedures and surgical techniques it can prevent or lessen the anemia associated with surgery and other medical procedures.

Planning Ahead -
With careful planning, several steps can be taken to help your body compensate for blood loss during surgery without the use of donor blood.  For example, a number of approved pharmaceutical agents are used to lessen or prevent anemia.  These include erythropoieten and iron, which are typically used prior to surgery to stimulate the bone marrow’s production of red blood cells.  These same agents can be used after emergency surgery to rebuild the red blood count.

Less is Better -  

New technology in the laboratory allows us to use fewer samples of blood, and sometimes only one sample of blood for multiple tests rather than the typical practice of drawing numerous different samples.  Furthermore, smaller amounts of blood, or microsampling, are now just as effective in testing as larger, conventionally sized samples.  By using fewer and smaller blood samples, we can significantly reduce the blood loss associated with essential diagnostic tests.

Meticulous Technique -

Blood loss during surgery can be minimized by using extra caution and deliberate operative techniques—avoiding small cuts, immediate clamping or cauterizing of bleeding vessels, etc.  The choice of instrumentation is also important.  For example, electrocautery, surgical lasers, and argon beam coagulators cause less blood loss than traditional cutting scalpels and help in the clotting of blood during surgery. Additionally, minimally invasive surgery, such as the use of endoscopic or laparoscopic technique, usually result in much less blood loss than traditional open forms of surgery.

Conserving Your Resources -

Thanks to major advances in surgical technology, blood lost during certain types of surgeries can be salvaged and recycled.  For example, blood that spills in the chest or abdominal cavity can be collected, filtered and re-infused in a continuous process.  This technique is commonly referred to as a “cell saver” and is particularly important when blood loss is due to a traumatic injury.  This technique is used in trauma as well as in the operating suite to ensure that as much blood is salvaged as possible.

Another method that can be used during surgery to conserve your red blood cells are hemodilution.  This method involves the drawing of blood, followed by the immediate infusion of intravenous fluids to replace the missing blood.  Any blood lost during the surgery will be diluted by the intravenous fluid and therefore fewer red cells are lost.  At the same time, the blood that was drawn is slowly returned via a continuous circuit that is linked to your circulatory system thereby replacing the lost red blood cells.

Respecting your Decision -

Lakewood Regional Medical Center is committed to providing the highest quality care to all patients who wish to avoid the use of blood transfusions.

While in the hospital, bloodless surgery and medicine patients are clearly identified to all relevant hospital staff to ensure their bloodless treatment plan is maintained at all times.  You and your family will be involved in every step of the diagnostic and treatment decision-making process and your wishes and beliefs will be respected.  The Program Coordinator is available to work with you and your family before, during and after hospitalization to answer your questions and to help ensure your satisfaction with our services. 

We encourage all patients to learn as much as possible about the positive benefits of bloodless surgery and medicine and to consider choosing this approach whenever possible.  The Program Coordinator is available to answer your questions and to help guide you in your decision.  Please call to speak with the coordinator at 562.602.6780.

*"Bloodless" means medical or surgical treatment without the use of banked (stored) allogenic blood or primary blood components.  Blood loss often occurs during surgery.   A bloodless program endeavors to minimize blood loss by utilizing special blood conservation methods.