Clinical Strategies in the Medical Care of Jehovah’s Witnesses

Remmers, Paul A.; Speer, Alice J.

doi:10.1016/j.amjmed.2006.04.016

Cited by 41 publications

(24 citation statements)

References 48 publications

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“…Management of JW patients with severe anemia, be it in the setting of trauma, acute blood loss perioperatively, or ACS, without transfusion of blood products, requires supportive care and the use of alternative therapeutic options that maximize DO2 and minimize VO2 [6][7]. This includes: (i) treatment of hypovolemic shock, if present; (ii) local hemostatic interventions (cauterization, fibrin glue) and use of pro-hemostatic agents such as aminocaproic acid; recombinant FactorVIIa; desmopressin to stop bleeding and high-dose recombinant erythropoietin with iron/B12/folate to stimulate erythropoiesis; (iii) ventilatory support to reduce work of breathing and assist with oxygen delivery.…”

Section: Discussionmentioning

confidence: 99%

Treating a Patient with Your Hands Tied: Acute Chest Syndrome in a Jehovah’s Witness

Vadehra

Davino

Datta

2020

Cureus

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Acute chest syndrome (ACS), a vaso-occlusive crisis in patients with sickle cell anemia, is a lifethreatening condition and a leading cause of death in these patients. It is treated with analgesics, antibiotics, intravenous fluid, supplemental oxygen (or ventilatory support in severe cases) with simple or exchange transfusion, being the mainstay of therapy. We report a young Jehovah's Witness (JW) patient with sickle cell anemia who presented with ACS. Her religious beliefs precluded the use of blood products. Despite concomitant hemolytic and aplastic crisis and a hemoglobin nadir of 3.1 g/dL, the patient was treated successfully with supportive care-including mechanical ventilation, sedation, paralysis, and erythropoiesis stimulation-and survived. A maximal supportive strategy consisting of ventilatory support with a high fraction of inspired oxygen, sedation, paralysis, erythropoiesis stimulation, and limitation of blood draws can result in the successful treatment of JW patients who refuse blood products.

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Section: Discussionmentioning

confidence: 99%

Treating a Patient with Your Hands Tied: Acute Chest Syndrome in a Jehovah’s Witness

Vadehra

Davino

Datta

2020

Cureus

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“…EPO is a glycosylated polypeptide released by the kidney in response to hypoxia which increases erythropoietic precursors in the bone marrow and has been shown to be a useful in avoiding transfusion in surgical specialties including head and neck [17,18]. Remmers et al suggested the use of EPO and iron 2 to 3 weeks before elective surgery in JW [19]. …”

Section: Discussionmentioning

confidence: 99%

Case report: The management of advanced oral cancer in a Jehovah's Witness using the Ultracision Harmonic Scalpel

et al. 2011

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We present the first case of a head and neck oncological procedure accomplished in a Jehovah's Witness using the Ultracision Harmonic Scalpel (Ethicon, Cincinnati, OH). Jehovah's Witnesses present a serious challenge to the head and neck cancer surgeon due to their refusal to accept transfusion of any blood products. However, our experience reinforces the view that surgical management of head and neck cancer is possible in these patients. We show the Harmonic Scalpel, an ultrasonic tissue dissector, to be a useful surgical tool in obviating the need for blood transfusion. Preoperative optimisation, intra-operative surgical and anaesthetic techniques are also fully discussed.

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“…The use of cell salvage may be acceptable by Jehovah's Witness as the blood remained in continuity with their body circulation (King, 2009;Remmers & Speer, 2006). However, its use in obstetric cases due to PPH is still viewed negatively for the potential fear of amniotic fluid embolism due to fetal cells, fat or faecal matter contamination.…”

Section: Jehovah Witnessmentioning

confidence: 99%

“…This procedure is also acceptable to the Jehovah's Witness as the replaced blood is in continuity with body circulation. However, this procedure is not without complication as it may cause cardiovascular instability (Remmers & Speer, 2006).…”

Section: Jehovah Witnessmentioning

confidence: 99%