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Date Posted: 19:32:55 02/15/07 Thu
Author: Vancomycin
Subject: Re: 輸血問題
In reply to: 愛你一世 's message, "輸血問題" on 19:12:53 02/15/07 Thu

哈哈﹐唔講transfusion前﹐先決定係唔係一定需要transfusion...

呢方面唔同醫院方針大致一樣﹐但亦有D subtle differences...

血(blood product)亦有好多種-->whole blood, red cell concentrates, FFE, platelet concentrates, FFP﹐所以「輸血」係個好籠統詞語。你所講1 unit "blood" ~ 450-500mL whole blood(但會先抽走platelet)﹐亦都比較少用...常用D係紅血球(post-detergent)+生理鹽水...好處係容易D準備但就怕ABOincompatability引起溶血。詳細情況､幾時用邊種每個專科(如腎科､血液科､免疫科)會有自己套準則。

有D人係唔可以輸血(如耶和華見證人信徒)同某D特別血液問題病人(如某種haemachromatosis)...有D人入急症室已經昏迷不醒大量失血﹐臨急要用plasma expander(如colloid/crystalloid)同O-neg blood...

至於責任問題﹐每間醫院有唔同clerking+cross check policy(係bureaucracy 多過實際)...不過基本上你係醫生﹐prescribe blood product時一定要小心。如果你冇prescribe錯但係faulted on delivery of product時﹐你亦有機會要上庭(雖然唔係你錯﹐但你係重要證人)。

到你第時上ALS courses會知多D :-)

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