Management of adult Jehovah's Witness patients with acute bleeding.
Because of the firm refusal of transfusion of blood and blood components by Jehovah's Witnesses, the management of Jehovah's Witness patients with severe bleeding is often complicated by medical, ethical, and legal concerns. Because of a rapidly growing and worldwide membership, physicians working in hospitals should be prepared to manage these patients. Appropriate management of a Jehovah's Witness patient with severe bleeding entails understanding of the legal and ethical issues involved, and meticulous medical management, including treatment of hypovolemic shock, local hemostatic interventions, and administration of prohemostatic agents, when appropriate. In addition, high-dose recombinant erythropoietin in combination with supplemental iron may enhance the speed of hemoglobin synthesis.
Berend
Kenrick
K
Department of Medicine, St. Elisabeth Hospital, Willemstad, Curaçao, Netherlands Antilles. kenber@attglobal.net
Levi
Marcel
M
D000208:Acute Disease; D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000628:therapy; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D001803:Blood Transfusion; D000075202:Contraindications; D004630:Emergencies; D004921:Erythropoietin / Q000627:therapeutic use; D006470:Hemorrhage / Q000628:therapy*; D006489:Hemostatic Techniques; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D033221:Jehovah's Witnesses; D018962:Phlebotomy; D011994:Recombinant Proteins; D012769:Shock / Q000209:etiology / Q000628:therapy; D016312:Treatment Refusal; D014474:Unconsciousness; D014812:Vitamin K / Q000627:therapeutic use
D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; D011994:Recombinant Proteins; D004921:Erythropoietin; D014812:Vitamin K; C025667:prothrombin complex concentrates