Patient Blood Management (PBM) and Bloodless Medicine FAQs

Nuvance Health supports you and your Patient Blood Management (PBM) and Bloodless Medicine preferences. 

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At Nuvance Health, we strive to maintain the standard of care and best practice for patient blood management, for all patients.  However, we understand that you may have many reasons for avoiding transfusions of donor blood or primary blood components (Whole Blood, Red Blood Cells (RBC), White Blood Cells (WBC), Platelets, and Plasma (Fresh Frozen Plasma ‘FFP’). Whatever you decide about the use about the use of blood products, blood fractions, and procedures utilizing your own blood, we respect your wishes and offer services that give you peace of mind. We partner with you and use a team approach to target care to your specific needs. You have choices when you come to us for care.
Patient Blood Management (PBM) and Bloodless Medicine FAQs

Here are answers to some common questions about Patient Blood Management (PBM) and Bloodless Medicine:

Why should I choose Patient Blood Management (PBM) and Bloodless Medicine?
Patient Blood Management (PBM) and Bloodless Medicine treatments and techniques may improve your safety by minimizing exposure to blood borne diseases and viruses. It may also reduce the length of your hospital stay and recovery time.

What is ‘Patient Blood Management’?

Patient Blood Management is a patient-centered, organized approach in which the entire health care team coordinates efforts to improve results by managing and preserving a patient’s own blood.

What are the goals of Patient Blood Management (PBM) and Bloodless Medicine?

  • To conserve your own blood
  • To reduce blood loss
  • To avoid unnecessary use of blood transfusions
  • To provide an extra layer of support if you request non-blood transfusion management of your care

If I choose Patient Blood Management (PBM) and Bloodless Medicine, will my own blood be used for testing and diagnostics?

Yes, it may be used for those purposes.

What is a blood transfusion?

When blood is removed from a donor’s vein (as ‘whole blood’), it contains four major components: red blood cells, white blood cells, platelets and plasma (FFP). The ‘whole blood’ is cleaned, processed and separated into those components. A transfusion is a medical procedure that adds the donor’s blood or any of its components to your blood.

If I request bloodless medical care, can I decide if there are any conditions under which I would accept blood products?

Yes. We want you to have the support you need at the level you need it. There are two main choices. You may refuse transfusions of whole blood or its components under any circumstances. You may also refuse transfusions except in life-or-death medical situations as a last resort. In addition, you may choose to accept or refuse minor blood fractions in your medical care. Please refer to the Patient Resources for more details.

What are minor blood fractions?
After the donor’s whole blood is cleaned, processed and separated into the four major blood components, proteins, enzymes, and hormones are extracted from each of them. These are called minor blood fractions (also derivatives or products). These products may also be derived from animals, such as pigs or cows. You may decide whether or not to accept them if you have requested bloodless care.

What are minor blood fractions used for?

Examples of minor blood fractions include albumin, thrombin, and clotting factors. They are used in medical care for many reasons, including to control bleeding, boost the immune system and help support your body to produce more red blood cells.

What kind of treatments and technology can be used to support my bloodless care needs?
The team closely coordinates care with your needs and preferences. Patient Blood Management (PBM) strategies may include: minimally Invasive surgeries, harmonic scalpel, lasers, argon beam coagulator and electrocautery, Arterial Embolization, Pharmaceuticals (some of these products may contain fractions), Pulse Oximetry, Hyperbaric Treatments (for some severe anemia cases), Volume Expanders, Low-Volume Blood Draws and use of i-STAT, and Anemia Management. For ‘personal choice’ options involving the use of your own blood that may be discussed with your provider, please see Patient Resources. 

How and when should I discuss my bloodless care wishes with my doctor?
You can discuss your bloodless care preferences at an appointment with your doctor prior to medical care or an emergency. You may also find it helpful to share your long-term wishes in advance with your loved ones and any healthcare agents.

If you need surgery, you can discuss your preferences with the surgeon at your initial consultation. Find additional information to help guide your discussion at Patient Resources.

Will my bloodless care wishes be honored?

At Nuvance Health, we respect the rights of all patients to make their own informed healthcare decisions. Be sure to alert all hospital staff about your bloodless care preferences, including registration staff, nurses, doctors, surgeons and other specialists.

If applicable, we ask that you provide us with hard copies of an Advance Directive and/or other legal documentation of your preferences, with each hospital encounter. This should be done at every point in your care, starting at registration. Advance Directive titles vary, but your bloodless care wishes may be included in documents such as:

  • Durable Power of Attorney
  • Healthcare Proxy
  • NO BLOOD Healthcare Proxy 
  • NO BLOOD Healthcare Representative
  • Healthcare Representative
  • Healthcare Surrogate