Medicine an Surgery notes

Apr 24th, 2015
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MRTH Department of Reproductive HealthGuidelines for the appropriate use of blood and blood productsAcute and Peri-operative Blood loss1. Evaluate patient for risk ischemia2. Estimate blood lossIf >30-40% of rapid blood loss: transfuse RBC's and use volume expanders.If < 30-40% of rapid blood loss: RBC's not usually needed in a healthy person.3. Monitor vital signsTachycardia and hypotension not corrected with plasma expanders: RBC's needed4. Measure HbIf Hb >10 g/dl: RBC's rarely neededIf Hb <5 g/dl: RBC's usually neededIf HB 5-10 g/dl: RBC's may be needed, determined by additional clinical conditions.Chronic anemia 1. Transfuse only to decrease symptoms and minimize risk (generally at Hb <5 g/dl) do not transfuse >5 g/dl unless patient is symptomatic.2. Treat nutrional and mild blood loss anemia with specific therapeutic agents as indicated (iron, folic acid B12)3. Use specific strategies for sickle cell disease and -thalaessemia (see section below)BLOOD TFANSFUSION IN PREGNANCYIn pregnancy, maternal plasma volume increases by 40%, and red blood cell mass by 25%. Blood loss is usually well tolerated during pregnancy. The mean blood loss during vaginal d

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