Transfusion Medicine

 A one-month rotation in transfusion medicine for residents in anesthesia is offered at the Civic and General Campuses of the Ottawa Hospital. The objective of this rotation is to provide the anesthesia resident with an environment that is conducive to acquiring the knowledge and practical experience with patients requiring the services of the transfusion medicine department.  Mandatory clinical and reading objectives as well as optional rotational clinical and reading objectives are listed below.  To meet the rotational objectives, the resident will spend time both in the transfusion medicine department as well as participate in hematology clinics, the consultation service and the autologous blood program at the discretion of the rotation supervisor. The objectives should be reviewed with the resident supervisor at the start of the rotation and used as a guide for the residents reading and clinical experience. The hospital library and transfusion medicine departments maintain current textbooks for reference.  In addition a current binder of the required reading material for anesthesia residents is kept in the anesthesia department libraries at the Civic Campus for use during this rotation.

 The co-ordinators of the transfusion medicine – hematology rotation are:

 Dr. Gail Rock and Dr. Janis Bormanis (Civic Campus) Tel: 761-4254 

Dr. Gail Rock and Dr. Bernard Olberg (General Campus)    Tel: 761-4254;   Tel: 737-8296

  

Mandatory Clinical Objectives:

 1.        To become familiar with the scope of available blood products, their source of production, and the indications and complications of transfusing blood products.

2.        To gain an understanding of serology, typing, screening and cross matching blood products.

3.        To become familiar with the practice of autologous donation.

4.        To understand how a transfusion reaction is investigated.

5.        To gain an appreciation of the infective risks of transfusion and how these risks are minimized using screening principles and other techniques.

6.        To gain experience in the investigation and management of patients with anemia, thrombocytopenia and coagulation disorders.

 

Mandatory Reading Objectives:

 

1.      Perioperative Transfusion Medicine.  Spiess BD, et al.  1998 Williams and Wilkins.

     Chapter 4:  Compatibility testing.

     Chapter 7:  Infectious risks of transfusion.

     Chapter 8:  Preoperative Autologous Donation.

     Chapter 22: Intraoperative conservation techniques.

 2.      Guidelines for Red Blood Cell and Plasma Transfusion for Adults and Children.  Can Med Assoc J 1997; 156(11)

3.      Clinical Guide to Transfusion.  Can. Red Cross Society 3^rd Edition.  1993
 

Optional Clinical Objectives:

 

1.      Approach to patients with special disorders: Sickle cell disease, polycythemia, autoimmune hemolytic anemia.

 2.      Perioperative assessment of the hypercoagulable patient.

 3.      Pharmacological approaches to limit bleeding in surgical patients.

 

Optional Reading Objectives:

 1.       Circular of Information for the use of human blood and blood components.  Can. Red Cross Society.  1994

2.    Perioperative Transfusion Medicine. Spiess BD, et al.  1998 Williams and Wilkins. Chapters15, 19, 26. 

Other references:     Mollison Transfusion textbook:  (good as a reference)

                                        AABB Technical Manual