Non-blood products for raising hemoglobin

Nurses General Nursing

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Specializes in Oncology.

We have a patient right now who's a Jehovah's Witness with a hgb of 6.0. He obviously won't receive a blood transfusion.

Has anyone ever seen hgb successfully raised, without blood, from a level that low?

He's also still actively bleeding.

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Specializes in Critical Care, Capacity/Bed Management.

Some non-blood products I have seen to boost Hemoglobin is procrit and ferrlocit (sp). I do not know how well they will work since the patient is still actively bleeding.

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From THAT low, raised to something WNL without a transfusion? No. But maybe someone here has.

And still actively bleeding...? Yikes.

Epoetin would take time...

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Nothing on the market. The polyheme trial ended early after patient morbidity and mortality increased in patients given polyheme. I understand a bovine hemoglobin product is undergoing trials in South Africa. Hemopure?

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Specializes in Neuro ICU and Med Surg.

Jehovah's Witnesses won't take blood products, so he is taking his own risk. I don't think they will even take synthetic due to the belief they are messing with God's will. The only thing I can think of off hand is Epogen. But I don't know how much it will help if they are actively bleeding

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Specializes in Med/Surge, Psych, LTC, Home Health.

Wow, I had the same situation happen to me one night. I had a patient whose hemoglobin was something like, 6.5. Doc gave an order for type and cross and give 2 units of blood. So I went to inform the lady that she would be receiving blood. She said "I can't take any blood, I'm a Jehovah's Witness." . So, went and called the doc "Um, she's refusing to take the blood"

"Why?"

"She's a Jehovah's Witness"

"You're KIDDING!"

So anyway, he came to the floor and spoke to her, I guess he tried to convince her to take the blood and informed her of the possible consequences if she did not; of course she still refused. We ended up transferring her to a local teaching hospital, where a synthetic blood product was actually being experimented with.

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Specializes in Neuro/Med-Surg/Oncology.

I did a search on bloodless medicine. This site came-up first. It seems like they have a lot of info and they may be willing to consult with your docs.

http://www.bloodlessmedicine.org/archive/

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Specializes in Medsurg/ICU, Mental Health, Home Health.
i don't think they will even take synthetic due to the belief they are messing with god's will.

the belief against blood transfusions isn't about the will of god. it's about cleanliness, ultimately. in the old testament, it was forbidden to have meat with blood in it (like rare steaks, that kind of thing), and jws believe that having the blood put in iv is the same as po. this law was concerning cleanliness, as all the dietary laws of the time were (and for those who do keep kosher, still are).

- jess

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Specializes in Acute Care.
Wow, I had the same situation happen to me one night. I had a patient whose hemoglobin was something like, 6.5. Doc gave an order for type and cross and give 2 units of blood. So I went to inform the lady that she would be receiving blood. She said "I can't take any blood, I'm a Jehovah's Witness." . So, went and called the doc "Um, she's refusing to take the blood"

"Why?"

"She's a Jehovah's Witness"

"You're KIDDING!"

So anyway, he came to the floor and spoke to her, I guess he tried to convince her to take the blood and informed her of the possible consequences if she did not; of course she still refused. We ended up transferring her to a local teaching hospital, where a synthetic blood product was actually being experimented with.

Isnt the doctor supposed to get a blood consent signed by the pt before they order prbcs?

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Specializes in Med/Surg, Homecare, UR, Case Mgt.
Isnt the doctor supposed to get a blood consent signed by the pt before they order prbcs?

Good point. But the answer is no. This is according to hospital policy & procedure. At my hospital the RN gets consent.

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Specializes in Oncology.
Isnt the doctor supposed to get a blood consent signed by the pt before they order prbcs?

At our hospital docs can order it all they want, but the blood bank won't release the blood without a current T&S and consent.

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Specializes in Pedatrics, Child Protection.

Would factor (can't remember the #---?8) be considered a blood product? If not, it may help with the active bleeding. Have only ever given Epogen in that situation, and no, it didn't help.

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