ARTICLES

Three Techniques to Reduce Blood Loss

John Yosaitis, MD |
MedStar Health Simulation Training and Education Lab (SiTel)
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What got me interested in bloodless medicine is that I’m primarily interested in giving the best care to our patients.

Bloodless medicine has had more impact on the successful outcome of surgeries and my patients’ health than anything else I’ve done throughout my career

We started coming up with techniques and allowing the hematocrits to go lower, and we started seeing better results – we started seeing our patients healthier, we started seeing them leave the hospital sooner, we started seeing their wounds heal faster, we just started seeing better outcomes.

It’s not an alternative therapy at all, in fact, myself and a lot of other physicians started doing it for the Jehovah’s Witness patients, but now we do it for everybody; it’s mainstream medicine now; it’s just better medicine.

There are three basic things we start out with: we keep patients very hydrated; if you let a patient get dehydrated, their blood’s more concentrated…so if you lose 1000 cc’s of blood, you lose less red blood cells.

The other thing is, we keep patients warm; warm blood clots better, so we don’t let a patient get too cold

And we don’t let their blood pressure get high; if you let a pressure get high in the operating room, there’s more pressure pushing the blood out.

Those three things alone, that anybody can do, will drastically decrease the amount of blood loss.

With those three techniques…you don’t need any extra tools or knowledge of techniques – you’re so far along the road to bloodless medicine and all of your patients will benefit.

Most people don’t like change. Physicians don’t like change. This is a change. This is a change in theory. Traditionally, we have triggers where we give blood. In bloodless medicine, we’re not using those triggers. It’s a different mindset. It’s a better mindset; it’s a better way to take care of patients.

So for me, in the past – I started medicine in the 80’s – giving blood was kinda cookbook. The hematocrit got below 30, I gave blood. It was automatic. Now I don’t have any trigger… it requires some more thought; it requires looking at the patient, it does, but it is so worth it; my patients are doing so much better after I developed that theory; after I welcomed bloodless medicine into my practice. It’s worth it for my patients, so it’s worth it for me.