..should say: " Prepare " - excuse me - "guinea pigs"? Shouldnt each patient decide for himself withouth being influenced?
TheWonderofYou
JoinedPosts by TheWonderofYou
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48
"Basics of Blood Management" by Dr. Petra Seeber and Dr. Aryeh Shander - Inaccuracies and Myth
by OrphanCrow inpatient blood management arose out of bloodless medicine and alternatives to blood transfusions.
pbm has been accepted as the standard of care in australia and has been implemented into the health care systems of other countries such as canada.
a prominent promoter of pbm has been aryeh shander from englewood hospital in new jersey.
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48
"Basics of Blood Management" by Dr. Petra Seeber and Dr. Aryeh Shander - Inaccuracies and Myth
by OrphanCrow inpatient blood management arose out of bloodless medicine and alternatives to blood transfusions.
pbm has been accepted as the standard of care in australia and has been implemented into the health care systems of other countries such as canada.
a prominent promoter of pbm has been aryeh shander from englewood hospital in new jersey.
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TheWonderofYou
OrphanCrow:
As if the sudden success of Bloodmanagement could save Jehovahs damaged reputation, that has been "besmirched" by senseless human sacrifices, watchtower prophecy and scandals like the high rate of child abuse and suicidals and as if the efforts to give Watchtowers victims a honorable place in the medicine school books-history - pardon text books - would ever compensate for their senseless deaths.
I am curious about the coming info about HLC. Are there HLC's in each cirlce, each country, each continent or only one worldwide? Are their HLC conventions each year. How do they update? What is their job in contrast to the physicians, the anaesthelogoist? Only talking about what the physicians already knows anyway? Translating jargon to non-expert patient? Producting - excuse me - "guinea pigs"?
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How Dangerous are Blood Transfusions really?
by TheWonderofYou inthis is a report about the successful implementation of the patientbloodmanagent in germany and prof. zacharowski as well as the business trip of his life with shocking facts about transfusions in his bag.. http://screenart.tv/portfolio/gefaehrliche-bluttransfusionen.
this year 2016 president obama and vice biden awarded german physicians prof. kai zacharowski with humanitarian award for patient safety.
the patient safety movement foundation set the goal to massively reduce the number of preventable deaths of hospital patients worldwide by 2020.
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TheWonderofYou
AIT is the economic operator of the project „Good Good Practices in the Field of Blood Transfusion“
The AIT Austrian Institute of Technology has been awarded a contract to develop "Good Practices in the Field of Blood Transfusion" by the Consumers, Health and Food Executive Agency (CHAFEA) of the European Commission. AIT will be joined by a group of three leading experts to jointly develop an "EU Guide for Member States on Good Practices for Patient Blood Management (EU-PBM)". http://www.pressetext.com/news/20140321006
Here is a link to the offical EU-project description from the Austrian Institut of Technology AIT
http://lisavienna.at/en/news/ait-european-patient-blood-management-pbm-project-started
Definition and Rationale of Patient Blood Management PBM is a multidisciplinary concept that primarily focuses on patient safety by (1) consequently avoiding and/or treating anaemia, (2) minimising blood loss and bleeding and (3) optimising the physiological reserve of anaemia. Studies have shown that this comprehensive strategy significantly minimises the use of allogeneic blood products and therefore reduces their adverse effects on patient outcome. It has also been demonstrated that PBM saves costs for health care systems.
The main objectives of the project are
1st to study and map blood use for different medical specialities,2nd to identify and describe regional and national differences in blood utilisation and PBM strategies,
3rd to identify good practices in PBM and
4th to develop an EU guide on good practices for PBM.
This guide, which targets healthcare professionals, has to be applicable in different hospital settings and to include an evaluation strategy by using key indicators.
The project team is led by Prof. Dr. Hans Gombotz, Head of the Department of Anaesthesiology and Intensive Care at the General Hospital in Linz, Austria. He has been a pioneer in developing the PBM concept over the past decade, including two ground breaking studies on the practice of blood transfusion in Austria.
Since AIT, with its leading experts Dr. Günter Schreier and Peter Kastner, already served as a Contract Research Organisation in these two preceding projects it is also in a good position to serve as the prime contractor in the EU PBM project, taking responsibility for project and information management as well as biostatistics.
Further members of the core project team are Prof. Dr. Dr. Kai Zacharowski, FRCA, (Department of Anesthesiology and Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt) and Dr. Axel Hofmann (Department of Anesthesiology, University Hospital Zürich and School of Surgery, University of Western Australia).EU-Contract Details : Tender report showing contract has been awarded on 27.11.2013.
http://ted.europa.eu/udl?uri=TED:NOTICE:5706-2014:TEXT:EN:HTML
Oviously the project runs since 3/2014 30 months until this year. PERTHNEWS reported about the project too. Estimated project costs about € 300,000 10 % of the Australian sum.
Under the 30-month EU contract, AIT has to develop pilot programs in five teaching hospitals, each with a minimum of 750 beds, that have “no or moderate’’ implementation of PBM. Initially, the project team must do a “baseline evaluation’’ of patient outcomes and transfusion risk and blood use at each hospital.
The team also has to do an overall evaluation of the pilots after a year, analysing the strengths and weaknesses of the program.Eu Joint Action No 676969 under EU Health Programme
Joint Action Vigiliance and Inspection for the Safety of Transfusion started 2015. € 2. 328.664.-
http://ec.europa.eu/chafea/projects/database.html?prjno=676969
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How Dangerous are Blood Transfusions really?
by TheWonderofYou inthis is a report about the successful implementation of the patientbloodmanagent in germany and prof. zacharowski as well as the business trip of his life with shocking facts about transfusions in his bag.. http://screenart.tv/portfolio/gefaehrliche-bluttransfusionen.
this year 2016 president obama and vice biden awarded german physicians prof. kai zacharowski with humanitarian award for patient safety.
the patient safety movement foundation set the goal to massively reduce the number of preventable deaths of hospital patients worldwide by 2020.
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TheWonderofYou
Between January 1979 and July 1989, 15 children of Jehovah's Witnesses underwent corrective open surgery for congenital heart disease (CHD) on cardiopulmonary bypass (CPB) under the supervision of Prof. Gomobtz. So it was he who implemented open heart surgery with J.W. children in Austria (Graz and Linz) and later he had 100s of J.W. patients who unterwent surgery. Prof. Gomotz is called "pioneer for less application of foreign blood (bloodless surgery)." The hospital Linz today needs 70 % less blood bottles than 10 years before. The department of Anasthesesiology of Linz is the oldest in the germanspeaking area. http://www.linz.at/presse/2014/201403_72667.asp
He emerated as head of the hospital but is active in the field of scientific research on the transfusion medicine and education. His expertise makes him an expert in this field obvioulsy not only in Austria but as well in Europe. Therefore it is clear that he is scientific leader of the EU-Project.
The new head of the department in Linz is Univ.Prof. Dr. Jens Meier who changed from university hospital Tübingen to Linz. The same Eberhard-Karls University Tübingen where Prof. Gombotz was active in scientific research too.
Referring the above mentioned open surgery with children here the abstract
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/1876516
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Prof. Gomotz was cited in Der Standard 2013: "Each patient in each hospital should be treated like a J.W.“
http://derstandard.at/1363706272043/Jeder-Patient-sollte-wie-ein-Zeuge-Jehovas-behandelt-werden
Excerpt
NEW POSSIBLITES
"For the majority of operations additional blood is not required. Members of Jehovah's Witnesses would therefore only be rejected if it was a question of "borderline cases" in which the blood loss had been too large or multiple diseases.
The blood-saving alternatives to blood transfusions seem not only for many operations to be possible - even individual studies came to the conclusion that Jehovah's Witnesses interventions survived more frequently than patients receiving blood transfusions.
At the heart surgery at the Cleveland Clinic in the US about were 1983-2011 a total of 322 JWs surgery – patients mainly underwent predominantly bypass and valve replacement surgery. Ten deaths were reported by the hospital - 3.1 percent less than in the comparison group.
TOO MANY BLOOD TRANSFUSIONS
Regardless of fact that avoiding a blood transfusion can have a postitive affect to the course of disease, blood products are used too many times: Two years ago a study by the Health Ministry (Austria) came to the conclusion that only every second blood bottle is really necessary in Austria“
The rest of the text deals with frequency of deaths, Prof. Gomotz, said that it that would happen „very seldom“ and that the patients decision would be respected and how in this extrem situation the process is handled in Austria.
http://derstandard.at/1363706272043/Jeder-Patient-sollte-wie-ein-Zeuge-Jehovas-behandelt-werden
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ls homosexuality really normal?
by atomant inl know animals do it but their animals.they dont live by a moral code.the thought of 2 men going for it is not normal.what are your thoughts?.
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According to one JW there can only be 1 of 3 reasons why you left.
by Bonsai ini asked an old jw friend of mine why so many baptized individuals leave the jw religion.
"did it ever occur to you, old friend, that maybe they know something that you don't know and have valid reasons for leaving?
", i asked.. his response set me back for an answer.
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How Dangerous are Blood Transfusions really?
by TheWonderofYou inthis is a report about the successful implementation of the patientbloodmanagent in germany and prof. zacharowski as well as the business trip of his life with shocking facts about transfusions in his bag.. http://screenart.tv/portfolio/gefaehrliche-bluttransfusionen.
this year 2016 president obama and vice biden awarded german physicians prof. kai zacharowski with humanitarian award for patient safety.
the patient safety movement foundation set the goal to massively reduce the number of preventable deaths of hospital patients worldwide by 2020.
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TheWonderofYou
prologos: Interesting possible sideeffect, we are already treated as playthings.
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How Dangerous are Blood Transfusions really?
by TheWonderofYou inthis is a report about the successful implementation of the patientbloodmanagent in germany and prof. zacharowski as well as the business trip of his life with shocking facts about transfusions in his bag.. http://screenart.tv/portfolio/gefaehrliche-bluttransfusionen.
this year 2016 president obama and vice biden awarded german physicians prof. kai zacharowski with humanitarian award for patient safety.
the patient safety movement foundation set the goal to massively reduce the number of preventable deaths of hospital patients worldwide by 2020.
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TheWonderofYou
The summary that appeared in the above mentioned article of the austrian medical journal sounds like it was a Watchtower draft. (google translated) https://medonline.at/2015/experten-roundtable-patient-blood-management/
The myth of the saving blood transfusion
Transfusion triggers and anemia tolerance. In transfusion triggers two groups can be distinguished. On one hand, the hemoglobin level is used as a trigger. Meier: "That's easy to understand, but does not meet the physiological needs of the patient." On the other hand there are triggers such as tachycardia, hypotension, ECG changes or central venous O2 saturation. "The golden bullet 'was here not yet found, among other reasons, because the anemia tolerance of the whole organism may be different from the individual organs," said Meier.
Situation in Austria. While PBM now studied in different countries, and partly such as was also introduced across the board in Australia, the concept in Austria is recognized in principle, but it is not yet implemented in the majority of Austrian hospitals. Exception is the Linz General Hospital, where the former head of the Department of Anesthesiology, University Professor. Dr. Hans Gombotz, has begun implementation of PBM. This was continued by his successor Univ.-Prof Dr. Jens Meier. Under the aegis of Gombotz were also the two "Austrian benchmark" studies "- both funded by the federal health agency - performed.
The first in 2007 published study showed the one hand a high degree of blood transfusions in several indications (knee and hip replacement, coronary surgery) and on the other hand a high degree of variability between individual hospitals within the same indication. So was for example transfusion rate in total hip 16-85 percent. And in 19 percent of patients had a preoperative anemia, which was not corrected before the procedure. compared to the first study, the second, in 2014 published, Austrian benchmark study showed a drop in the average rates of transfusion in orthopedic procedures (from 41 to 30 percent for hip replacement and from 41 to 25 percent for knee replacement), but not in aortocoronary bypass (57 vs . 55 percent).
As before, there was the problem that the majority of preoperative anemia is not corrected adequately. Specifically, the annual consumption of foreign blood is around 50 units per 1,000 inhabitants, is the stated objective is 20 / 1,000. the transfusion volume decreased by 70 percent - at Linz General Hospital, which focuses on PBM, was within eight years - with an unchanged mortality.
Although I dont understand the scientific details I draw your attention to Prof. Gombotz who already retired.
For many years he was chief of the hospital department in Linz where hundreds of J.W. got a treatment, while other hospitals even refused to care for J.W. patients at least in one case. So obviously Linz became center of excellence beginning with 2001. The creation of centers of excellence all over Austria were his last efforts as head of the department. There is no inidication that he is member of J.W.
But already before Prof. Gombotz in Graz treated hundreds of J.W.
Quote: In 2001 he became New Head of Anesthesiology Linz.
Since yesterday, February 1, 2001, Univ.-Prof. Dr. Johann Gombotz the new Head of Anesthesiology and Intensive Care. Previously, he was Deputy Head of the Department of Anesthesiology for Cardiovascular Surgery of the University Hospital Graz. Univ.-Prof. Dr. Johann Gombotz has significantly contributed in Graz in building the emergency system. With more than 500 helicopter missions he is one of the most experienced flight doctors. Since 1990 has Univ.-Prof. Dr. Johann Gombotz about the teaching qualification for the subject anaesthesiology and intensive care. The new Head of anesthesia is 52 years old, married and has a son.
Under the participation of Univ.-Prof. Dr. Johann Gombotz developed at Graz University special blood saving methods and then used. Using this method far more than 100 Jehovah's Witnesses were successfully operated without allogeneic open heart. Also at the Linz General Hospital will in future increasingly used such methods.
http://www.linz.at/presse/archiv/2001/010202.htmAlready 1989 the reports titled 10 years operation at J.W. on open heart.
First Austrian Benchmarkstudy 2007
https://www.ncbi.nlm.nih.gov/pubmed/17655591
Second Austrian Benchmarkstudy 2014
https://www.ncbi.nlm.nih.gov/pubmed/24805865
____Concept of PBM by Prof. Gombotz
http://www.bmgf.gv.at/cms/home/attachments/5/8/1/CH1220/CMS1300956828837/05_gombotz_hans_pbm-konzept.pdf
Further similar lectures form 2011 by Prof Hans Gombotz and others like Hofmann, Rehak adressing benchmark study at the austrian gov. site.
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How Dangerous are Blood Transfusions really?
by TheWonderofYou inthis is a report about the successful implementation of the patientbloodmanagent in germany and prof. zacharowski as well as the business trip of his life with shocking facts about transfusions in his bag.. http://screenart.tv/portfolio/gefaehrliche-bluttransfusionen.
this year 2016 president obama and vice biden awarded german physicians prof. kai zacharowski with humanitarian award for patient safety.
the patient safety movement foundation set the goal to massively reduce the number of preventable deaths of hospital patients worldwide by 2020.
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TheWonderofYou
Here is a newer lecture of Dr. Hofmann as flash, which he held at the Anemia 2015 in Madrid.
You can listen to the full lecture and read at the same time or download the pdf.
http://www.anaemiacourse.com/anaemia_2015/data/09/09.pdf
Included is his usual disclosure, which shows from which institutions or enterprises who financially supported him as consultant.
Select him or any other speaker after skipping the intro.
Another lecture which he held in 2011, about health economic aspects held at a symposium for the Austrian Government. http://www.bmgf.gv.at/cms/home/attachments/5/8/1/CH1220/CMS1300956828837/04_hofmann_axel_gesundheitsoekonom_aspekte.pdf
Lecture 2012 at Austrian hospital addressing USA, Australia and Austria,
Interview A. Hofmann about the nervosity on the blood market [translate with google translate from german to english]
Expert roundtable 2015 adressing PBM [translate with Googletranslate from german to english]
https://medonline.at/2015/experten-roundtable-patient-blood-management/
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How Dangerous are Blood Transfusions really?
by TheWonderofYou inthis is a report about the successful implementation of the patientbloodmanagent in germany and prof. zacharowski as well as the business trip of his life with shocking facts about transfusions in his bag.. http://screenart.tv/portfolio/gefaehrliche-bluttransfusionen.
this year 2016 president obama and vice biden awarded german physicians prof. kai zacharowski with humanitarian award for patient safety.
the patient safety movement foundation set the goal to massively reduce the number of preventable deaths of hospital patients worldwide by 2020.
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TheWonderofYou
There is a study that Farmer S. (shannon) and Shander A published together, one of those countless studies
Five drivers shifting the paradigm from product-focused transfusion practice to patient blood management.
Hofmann A1, Farmer S, Shander A.
These are:
- the aging population with a leveraged demand for blood products opposed to a shrinking donor base;
- the growing awareness that transfusion is a complex service involving many different cost centers within a hospital and representing a multiple of the blood product cost;
- the continuous effort to protect blood pools from known, new, or re-emerging pathogens while facing uncertainty over their potentially long silent carrier states;
- the emerging evidence that transfusion is an independent risk factor for adverse outcomes;
- and finally, a lack of evidence for benefit of transfusion for the
vast majority of recipients.