Blood Product Refusal

Nov 23, 2023

Any competent adult may refuse to receive blood products!

One in every 360 Australians identify as a Jehovah’s Witness, and this is the most common patient group you will encounter who refuse blood products. 🩸❌

The most important thing your team needs to do is ensure you have a clear understanding of the patient’s wishes and a valid advance health directive in whichever format is relevant in your region. πŸ“βœ…

Jehovah’s witnesses will accept:
Crystalloid fluid (NS, Hartmann’s, Dextrose) βœ…
EPO that doesn’t contain albumin βœ…

Jehovah’s witnesses will NOT accept:
Whole blood that has left the circulation ❌
Packed red cells ❌
Platelets ❌
FFP ❌

Interventions that require clarification:
πŸ‘‰ Intraoperative cell salvage
πŸ‘‰ Clotting factor concentrates
πŸ‘‰ Albumin
πŸ‘‰ Cryoprecipitate

When there is any bleeding risk and time permits, there should be a multidisciplinary discussion involving the anaesthetic team, the surgeon the patient and possibly a haematologist. There are several effective strategies that can be implemented to improve outcomes in the setting of blood product refusal. πŸ™‚

Build knowledge βœ…
Improve safety βœ…

Refs
https://academic.oup.com/bjaed/article/4/2/35/271642

https://www.jw.org/en/jehovahs-witnesses/worldwide/AU/

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