Patient blood management
About patient blood management
Patient blood management (PBM) is a standard of care in medicine and surgery which seeks to maximise the use of a patient’s own blood and avoid unnecessary blood transfusions during surgery.
PBM improves patient outcomes by ensuring that the focus on the patient’s medical and surgical management is on improving and conserving the patient’s own blood. As a result, patients usually require fewer transfusions of donor blood, thus reducing the risk of transfusion associated complications.
By planning ahead, PBM helps to conserve your own blood during surgery or medical treatments which have a known risk of blood loss.
How does PBM work in practice?
PBM involves three basic principles:
Optimise a patient’s blood levels before a surgical or medical treatment
- Identify and treat anaemia (low blood levels of haemoglobin)
- Identify and treat nutritional deficiencies including iron, folic acid and vitamin B deficiency (low blood levels)
- Identify any coagulation (clotting) abnormalities needing correction or management.
Minimise blood loss during the treatment
- Certain medications, including some natural medicines, herbal and vitamin preparations, can increase bleeding or clotting at the time of a procedure. These may need to be stopped anywhere from a few days to several weeks before a procedure (Always consult your doctor before stopping prescribed medication)
- Some underlying diseases can interfere with the blood’s ability to clot. This may increase bleeding during a procedure and therefore may require treatment ahead of time
- Established equipment and anaesthetic techniques can be used to reduce bleeding; for some procedures specialized equipment may be used to recycle your own blood during and after your operation
- Provide medications that reduce bleeding
- Take smaller and less frequent samples of blood for testing.
Optimise recovery
- Intravenous fluids (a drip in your arm) are available to restore and maintain circulatory volume immediately after a large bleed.
- Medications and nutritional support can help support the body make new blood cells.
What are the risks of blood transfusion?
Transfusion is a key part of modern healthcare but it’s not without risks. Despite significant improvements in product safety through careful donor selection and infectious disease testing, errors and adverse transfusion reactions still occur. These adverse events can lead to poor clinical outcomes for patients and longer hospital stays. Fortunately, adverse reactions are rare. The most common reaction is a mild fever, which occurs in less than one in one thousand transfusions. None the less, we do focus on strategies to reduce or avoid the need for a blood transfusion where possible, alongside the appropriate use of blood when a transfusion is needed.
Why PBM is good for the blood supply
- Stocks of donated blood can sometimes be very low. PBM helps to reduce demand on Australia’s blood supply.
- The increased demand for red cells puts pressure on our limited donor base.
- Blood collection, distribution and administration expenses are costly.
- It is becoming more of a challenge to maintain an adequate blood supply.
As the population ages these challenges will grow.
More information
A doctor will decide whether you require a transfusion after careful consideration. The doctor will discuss the reasons for transfusion and explain the transfusion risks, benefits any alternatives which may be available to you, before obtaining your consent.
As a patient you have the right to participate in the decision-making process regarding your treatment and care and it is important that you discuss with your doctor any questions or concerns.
Before your doctor commences a treatment and care plan you will need to provide ‘consent’, making it important that you understand the process. If you have any questions concerns or fears it is very important that you discuss them with your doctor.
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.