I give lectures on Blood Conservation and
especially on "Appropriate Clinical Use of Blood" to clinicians,
nurses and medical scientists as well as being a Member of the College of
Primary Care Physicians (CPCPZ), Zimbabwe.
During my 14 years as Director, Blood
safety and Clincal Technology at WHO, Geneva, Switzerland, I published, amongst
many other publications, the Manual on "Appropriate Clinical Use of
Blood", which is in the format of a Clinician's pocket handbook and also
as a full Manual for each Hospital Ward and Operating Theatre.
These publications were evaluated and
assessed at global level, which is covered by WHO"s 6 Regional Offices and
had to be evaluated against all conventional and documented evidence based
materials (such as the well quoted "Cochrane Review", before WHO
would translate and publish these into all 6 WHO official languages and at
least 5 other languages, and many other languages. They have been published in
hard copy and through the WHO's Web Page for global electronic access.
During the development I was also invited
to present this material at a meeting hosted by the New York Academy of Medicine
and at a NATO Conference, in Washington, on blood management and blood conservation for Nato Troops. In
addition the concerns and philosophy of the Jehovah's Witness were addressed,
through direct face to face discussions with their principals in USA and UK.
The overall message is that blood should
only be administered to save a life or prevent severe complications of
morbidity. The Blood Transfusion Service is heavily involved in lectures and
promotional materials to ensure these principles are promoted at undergraduate
and postgraduate levels. Clinicians are encouraged to ensure that they take
responsibility to adhere to the principles incorporated in these materials,
based on WHO's Recommendations and Guidelines, and take responsibility for
their decisions and actions and are accountable.
In cases of emergencies there is often no
alternative other than to replace the only Oxygen carrying product – Red Blood
Cells. In chronic conditions, where the patient is stable, conservative
management is always encouraged. The web pages referred to provide useful
information for promoting appropriate clinical use of blood through transfusion
and encouraging alternatives to "Volume Replacement" and red cell
production, in a stable patient; (unrelated to red cell oxygen carrying
capacity to sustain life or prevent tissue or neuronal damage, when the
haemoglobin levels fall too low to ensure tissue oxygenation, with the result
of permanent damage or death).
I shall be prepared to meet, face to face,
with the correspondents, if they are genuine and wish to engage in a
constructive medical and physiological discussion, other than a faith
based ideological discussion; they may e-mail me directly and I shall provide
them with an opportunity to debate their views with me, directly.
Kind regards.
Dr Jean C Emmanuel MD
Consultant
Medical Director
National
Blood Service, Zimbabwe
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