EMMC Blood Management Program Part One 

This story is about blood and we’ll be going into an operating room. We want to let you know that in advance just in case you’re squeamish about such things.Blood management, or blood conservation, first came into play at Eastern Maine Medical Center in Bangor nearly four years ago.It’s a concept that’s been around for awhile, particularly in Europe, Canada, and Australia.But in the United States, there are few programs like it.”Patient blood management is essentially the application or implementation of timely use of strategies to improve or optimize a patient’s blood count, minimize blood loss during their hospital stay.”When the concept was first brought to Eastern Maine Medical Center by Medical Director Irwin Gross, it was mainly concentrated on cardiac and orthopedics patients.”Because these are patients at high risk for transfusion. Their surgical procedures involve significant blood loss and as a result they’re more likely to require a transfusion during their hospital stay.”Since implementing the program, they’ve been able to reduce their overall transfusion rates to about 55 percent.”That translates not only just better outcomes for patients, but a significant cost savings for the hospital.”Eastern Maine Medical Center is making strides with this program and it’s putting them on the map.”In the United States, relatively few programs, probably in the range of 100 or 120 nationally and within New England. EMMC is the first hospital to organize a formal patient blood management program.”They’ve recently been accredited for their perioperative blood collection program too.”We collect the patient’s own blood, wash it and return it to the patient. We’re actually about 1 of 25 programs in the US.”Doctor Robert Clough, Chief of the Cardiovascular Service, says there’s a lot of risk to using just one unit of blood.But with the blood collection program, the risk is lessened.”You saw the nurses collect every sponge and it’s rinsed and put through the cell saver so the cells can be given back to patients. So we really don’t waste any blood, that’s the goal.”The cell saver machine is an important part of the blood collection.”It’s a way of taking blood from the operative field and spinning it and filtering it and removing things that might be harmful.””Usually people wouldn’t have a reaction to it. It’s good healthy blood.”The blood they collect is mixed with heparin, which is then washed out, along with broken or damaged cells.They say whenever you do any type of surgery, it’s likely blood cells will be broken.”So all those broken and damaged cells are gotten rid of through a waste bag so that all we’re giving back is packed red blood cells.”This program has changed a lot of the staff’s roles during surgery.A perfusionist runs the heart monitor during the surgeries. They’re responsible for keeping the patient alive while the surgeon operates on a still heart.”The machine consists of a pump like your own heart and a lung. We basically circulate blood through the membrane among other things as well as blowing off carbon dioxide, adding oxygen in order to give that oxygen its blood back to the patient and it’s a constant recirculation.” The hospital is now beginning to use the Blood Management Program in other forms. They say it’s always their goal to avoid blood transfusions, if they can.