title: Management of bloodless surgery in a trauma setting. Balancing patient wishes with safety.
abstract: Many patients refuse blood or blood products because of religious beliefs or fear of complications. At Hennepin County Medical Center, a multidisciplinary team developed a Bloodless Surgery Medicine Guideline (BSMG) to help identify those who refuse blood products, guide medical decision-making, improve documentation of informed consent or refusal, and ensure continuity of care for patients. To our knowledge, this is the first documentation of a guideline for managing informed consent for or refusal of blood or blood products in trauma patients. This article discusses the development of and legal rationale for two key components of the BSMG: an informed consent/refusal algorithm and a blueprint for discussing the use of blood or blood components with patients and documenting their decisions.
authors.affiliation: Department of Surgery, Hennepin County Medical Center.
authors.forename: Kaitlin
authors.initials: K
authors.lastname: Gaddie
authors.forename: Crystal
authors.initials: C
authors.lastname: Montgomery
authors.forename: Sherrie
authors.initials: S
authors.lastname: Murphy
authors.forename: Jed
authors.initials: J
authors.lastname: Gorlin
authors.forename: Michael B
authors.initials: MB
authors.lastname: Miller
authors.forename: Brenda
authors.initials: B
authors.lastname: Anderson
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Nygaard
authors.forename: Chad J
authors.initials: CJ
authors.lastname: Richardson
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Ney
mesh_terms: D000465:Algorithms; D057668:Bloodless Medical and Surgical Procedures / Q000331:legislation & jurisprudence*; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D008910:Minnesota; D010348:Patient Care Team / Q000331:legislation & jurisprudence; D026684:Personal Autonomy; D012449:Safety / Q000331:legislation & jurisprudence*; D016312:Treatment Refusal / Q000331:legislation & jurisprudence; D014947:Wounds and Injuries / Q000601:surgery*