Your Patient Blood Management program can be so much more! Carolyn Burns shows you how to make wiser PBM choices today.
Backing Up For a Second
There’s a pretty good chance that whatever your PBM program looks like, it could do much MORE. If you are monitoring transfusions for appropriateness, for example, how about diagnosing anemia earlier so that transfusion isn’t needed at all? Or what about using antifibrinolytics to stop bleeding before a patient even gets to the point of transfusion? Or, and this is a big one, does that patient REALLY need those daily lab draws? All of these issues (and more) are things that SABM believes all facilities should do better, and that’s the point of this interview.
My friend Dr. Carolyn Burns is a SABM Board Member, and an independent consultant for Patient Blood Management initiatives. She was intimately involved in developing the Choosing Wisely document. Carolyn joins me for a quick-moving discussion of some overall philosophies of PBM, and discusses each of the five questionable practices in detail.
To me, the use of plasma outside of an exsanguinating hemorrhage protocol or for therapeutic plasma exchange for TTP…isolated orders for plasma should be questioned. They should be thought about very, very carefully, because most often they’re not needed.
About My Guest:
Carolyn Burns, MD is a Board-certified Anatomic and Clinical Pathologist. After earning her Microbiology degree from the University of Kansas, and her MD from the University of Missouri, Dr. Burns completed an internship in General Surgery followed by Pathology residency at the University of Louisville. She was Chief of Pathology for the Jewish Hospital Healthcare System Department of Pathology in Louisville, KY from 1991-2011. She has previously been an Assistant Clinical Professor in the Dept. of Pathology at the University of Louisville and on the Advisory Board and guest lecturer for the Bellarmine University Clinical Laboratory Science Program. Carolyn currently serves as a physician advisor for the American Red Cross Blood Center, River Valley Region.
Dr. Burns is an active member of several medical societies including AABB, College of American Pathologists, American Society of Clinical Pathologists (where she serves on the Education Committee), and the Society for the Advancement of Blood Management (SABM) where she serves on the Board as Treasurer and is the editor of the SABM Newsletter. Dr. Burns is a board member, as well, for the Kentucky Association of Blood Banks.
Dr. Burns is a passionate advocate for Patient Blood Management, has been published in peer-reviewed journals and textbooks, and is often sought as an engaging speaker on diverse transfusion topics.
This podcast episode offers a FREE continuing education activity where you can earn the following types of credit: 1 AMA PRA Category 1 CreditTM, 1 ASCLS P.A.C.E. ® Contact Hour (including Florida Clinical Laboratory Credit), and American Board of Pathology Self-Assessment Modules (SAMs) for Continuing Certification (CC, formerly MOC).
To receive credit and review the accreditation information and related disclosures, please visit Transfusion News Continuing Education on Wiley Health Learning.
DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. Burns nor I have any relevant financial disclosures.
- SABM Choosing Wisely List: From the SABM site.
- Consensus statement on pre-operative iron-deficiency anemia: Muñoz M et al. International consensus statement on the peri‐operative management of anaemia and iron deficiency. Anaesthesia 2017;72:233-247.
- CRASH-2 Trial: Summary in pdf book form
- WOMAN Trial: WOMAN Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet 2017;389:2105-2116.
- Article in 2002 Forming foundation of Choosing Wisely: Medical Professionalism in the New Millennium: A Physician Charter. Ann Intern Med. 2002;136:243-246.