Trauma e transfusão sanguínea precoce: o desafiante manejo de hemorragias em Testemunhas de Jeová.

Lima, Giacomo Lamarão; Byk, Jonas

doi:10.1590/0100-6991e-20181974

Cited by 3 publications

(7 citation statements)

References 15 publications

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“…Treatment of patients declining transfusion of blood components challenges medical staff ethically and clinically. 6,13,15,28 components as well as blood loss. 2,4,11,12,23,29 Minimising blood loss perioperatively reduces risk of adverse events.…”

Section: Discussionmentioning

confidence: 99%

“…The survey's questionnaire was based on the literature published by JW and medical literature on transfusion. [5][6][7]9,12,13,20,[23][24][25][26]…”

Section: Methodsmentioning

confidence: 99%

“…11 All though care of patients declining transfusions of blood components are infrequent, the clinical dilemma as well as the ethical implications can impact both patients, physicians and other healthcare persons involved in the care. 3,[12][13][14][15][16] Specifically when dealing with major haemorrhage the treatment of patients declining transfusions of blood component can be challenging. [16][17][18][19][20] Legally, in Denmark adult patients have the right to decline transfusion of blood components even if it results in fatality.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative management of patients declining transfusions of blood components—National survey of anaesthesiologists, abdominal surgeons and obstetricians in Denmark

Jauho

Skovmand

Cedergreen

et al. 2023

Acta Anaesthesiol Scand

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Perioperative management of patients declining transfusions of blood products can be challenging both ethically and clinically. Jehovah's Witnesses (JW) decline treatment with blood products and have published a list of interventions they might accept as substitutes. No detailed documentation of available substitute interventions at Danish hospitals exists. Likewise, no national guidelines exist on how to optimise patients who refuse to receive treatment with blood products. The primary aim was to investigate which treatments are currently available to healthcare professionals in Denmark when treating patients who refuse transfusion of blood components. Additionally, we wanted to investigate how many departments have local guidelines for treatment for this group of patients. Based on our findings we would suggest potential improvements in the treatment of patients declining transfusion of blood components. Consultants from Danish departments of anaesthesiology, abdominal surgery and obstetrics were invited to participate in a nationwide cross‐sectional online survey. The questionnaire explored available interventions offered perioperatively. Respondents were all on‐call consultants. The questionnaire underwent content, face and technical validation during pilot testing. Ninety‐six of 108 (89%) respondents from 55 departments completed the questionnaire. Thirty‐five (36%) respondents reported having a departmental guideline mostly dealing with judicial aspects regarding patients declining transfusions with blood, and 34 (35%) would in collaboration with other professionals make an interdisciplinary strategy for patients declining transfusions with blood. For patients declining treatment with blood products in anticoagulant treatment, and hence with a greater risk of bleeding, reverting treatment is essential. Depending on the type of anticoagulant, between 31 (32%) and 59 (60%) of respondents reported locally available guidelines for reverting anticoagulant treatments. We found a considerable variation and limited availability of interventions to minimise blood loss in patients declining transfusion of blood components. This scarcity of local guidelines together with the considerable variation of available treatment documented in our survey could possibly be enhanced by a lack of national guidelines.

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Section: Discussionmentioning

confidence: 99%

“…The survey's questionnaire was based on the literature published by JW and medical literature on transfusion. [5][6][7]9,12,13,20,[23][24][25][26]…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perioperative management of patients declining transfusions of blood components—National survey of anaesthesiologists, abdominal surgeons and obstetricians in Denmark

Jauho

Skovmand

Cedergreen

et al. 2023

Acta Anaesthesiol Scand

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“…In the face of transfusion reactions, some care procedures mentioned in the study refer to the availability of equipment for emergency and ventilatory support, interruption of the transfusion, maintaining permeable venous access and communicating the reaction to the blood center by sending the bag and blood equipment for analysis [16][17][18][19], as well asa compulsory notification of transfusion reaction in Brazil [24].…”

Section: Discussionmentioning

confidence: 99%

Nursing care in the transfusion of blood components to surgical patients in the perioperative period

et al. 2021

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Introduction: blood transfusion consists of the administration of blood components intravenously in clinical or surgical treatments. In the preoperative period, it is performed with the objective of improving tissue oxygenation, as well as promoting hemodynamic and hemostatic balance. Objective: to understand nursing care in the transfusion of blood components to surgical patients in the perioperative period. Method: this is a descriptive and exploratory study with a qualitative approach. Grounded Theory was used, with constant comparative analysis. A total of 18 nurses and 28 nursing technicians from a university hospital took part in the study. Data were collected between October 2019 and February 2020, through a sociodemographic questionnaire and semi-structured interviews. Results: the study resulted in the central category nursing care during transfusion, which gave rise to the categories: caring for before transfusion; caring for during transfusion; and caring for after transfusion, which were discussed according to the standardized nursing methodology. Conclusion: it was understood that nursing care is planned and implemented following an ordering of practices in a logical sequence due to the characteristics of the procedure in the perioperative period. Nurses demand indirect care; in contrast, nursing technicians engage in direct patient care.

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“…Na hipótese de não haver possibilidade em optar por tratamentos alternativos, estes religiosos negam-se submeterem a transfusões, ainda que essa decisão consequentemente os levasse à morte. Mesmo em casos de emergência, estes fiéis sustentam suas doutrinas, preferindo a liberdade religiosa e de consciência em contradita à vida (LIMA & BYK, 2018).…”

Section: Introductionunclassified

O Dever Ético Jurídico Dos Profissionais De Saúde Diante Da Recusa À Hemotransfusão a Partir De Preceitos Religiosos Das Testemunhas De Jeová

Flores¹,

Couto²,

Santos³

et al. 2023

Rev. Foco

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Apesar de diversas vezes debatido entre os religiosos adeptos à doutrina das Testemunhas de Jeová e os atuantes na seara jurídica e da saúde, a problemática da transfusão de sangue em tratamentos médicos ainda gera grande embate nos dias atuais. Esse conflito nasce quando há um choque entre alguns direitos básicos previstos na Constituição Federal, a liberdade religiosa e o direito à vida. Por um lado temos um grupo religioso que se recusa a receber sangue de terceiros por afronta à sua crença e preceitos bíblicos; de outro, a medicina sustentando que a vida é um direito absoluto e todo profissional da saúde possui o dever ético de seguir intrinsecamente o juramento realizado perante o Código de Ética, ou seja, realizar o tratamento transfusional ainda que contra a vontade do paciente e assim esquivar de sofrer penalizações por deixar de prestar o devido socorro ao paciente. Sendo assim, o impasse iniciado é alvo de inúmeras discussões, se traça uma interessante controvérsia na perspectiva jurídica brasileira conflitando o acolhimento da Constituição ao tratar sobre o direito à vida com as premissas ético-religiosas.

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Trauma e transfusão sanguínea precoce: o desafiante manejo de hemorragias em Testemunhas de Jeová.

Cited by 3 publications

References 15 publications

Perioperative management of patients declining transfusions of blood components—National survey of anaesthesiologists, abdominal surgeons and obstetricians in Denmark

Perioperative management of patients declining transfusions of blood components—National survey of anaesthesiologists, abdominal surgeons and obstetricians in Denmark

Nursing care in the transfusion of blood components to surgical patients in the perioperative period

O Dever Ético Jurídico Dos Profissionais De Saúde Diante Da Recusa À Hemotransfusão a Partir De Preceitos Religiosos Das Testemunhas De Jeová

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