Practices for the Jehovah Witness for Technicians

Jehovah Witness’s do not accept blood products, including their own, because of their religious laws and the doctrine of their Bible. (Watch Tower Bible and Tract Society of Pennsylvania 2000). It is the due diligence of the medical staff involved with the care of the patient to adapt the care to the religious beliefs. One of the means of practicing this is the use of cell saver. In the 1980’s The Watchtower accepted the use of cell saver when a closed circuit is set up. The belief is that the continuous loop is an extension of the patient’s circulatory system, and that the blood does not truly leave the body. The Watch Tower also states that certain fractions of the blood may also be accepted. On June 15, 2000 The Watch Tower published a document stating acceptable practices of a bloodless surgery, which included a closed circuit cell savage machine. (Watch Tower Bible and Tract Society of Pennsylvania 2000). Although the Watchtower approves of this practice, it is up to the patient’s own conscious decision on how they want their blood handled during surgery. HemaSource strives to provide the best care to all of their patients. The following steps are taken by HemaSource to ensure that the beliefs and wishes of patients who are Jehovah Witness are respected and followed:

1. Provide information to the regarding closed circuit Autotransfusion set up and the approval of the Watchtower

2. Determine the patient’s preferences 3. Set-up Cell-saver Elite in continuous loop per patient preferences

Autotransfusion for the Jehovah’s Witness Patient Document #: TCH-ALL-1003

Version #: 1

Title: Autotransfusion for the Jehovah’s Witness Patient

Effective Date: 06/17/2011

Principle: To provide instructions for the set-up and processing of autotransfusion

equipment for the preferences of a Jehovah’s Witness patient. Scope: HemaSource Technicians Notes: The preferences of a Jehovah’s Witness patient can vary widely based on

individual religious beliefs. Some Jehovah’s Witnesses will refuse autotransfusion; some will indicate that the regular autotransfusion procedure is acceptable to them; while a large number (usually the majority) will deem the continuous circuit setup their preference. Some surgeons/cases/patients will request that autotransfusion is present in a purely standby status and not set up (In that case, the technician will have all equipment and disposables in the room and stay in the room during the entire procedure).

Prior to the beginning of the case, when it has been established that

autotransfusion is ordered and that the patient is a Jehovah’s Witness, determine what that patient will prefer. If the anesthesiologist and/or surgeon has met with the patient and discussed their preferences, ask how they would like you to proceed. When possible, introduce yourself to the patient prior to the case and ask if they have any questions or special instructions for you regarding their preferences. If the patient requests a continuous loop set-up, proceed with the following procedure.

Procedure:

1. Set up the machine in a continuous loop before the surgery begins 2. Set up all equipment and disposables as if ready to process a bowl, including a

40µ filter (or other filter if applicable) and blood transfer bag. 3. Ask the Anesthesiologist to spike into the blood transfer bag with IV tubing

connecting to the patient 4. Use the wash mode to bring about 50 mls of saline into the bowl 5. Use the empty mode to draw about two thirds of that saline up into the blood

holding bag and then allow some of that saline to drip into the blood transfer bag 6. Have the Anesthesiologist spike the blood transfer bag with the the IV tubing and

then open that line to prime it with the saline from the blood transfer bag 7. Use return mode to send remaining saline in bowl to the blood collection

reservoir 8. Prime suction line with anticoagulant as normal 9. Now the entire loop is primed with fluid and ready for processing as indicated

 

 

 

 

References

Carroll, MS RN-BC, CEN, RRT, P. (2012, Summer). Autotransfusion for Jehovah's Witness Patients. Retrieved February 28, 2017, from http://www.atriummed.com/EN/chest_drainage/Clinical%20Updates/ClinicalUpdateSummer2012.pdf Grundy, P. (2015, March). Jehovah's Witnesses and the Watchtower's changing stance on blood transfusions. Retrieved February 28, 2017, from http://www.jwfacts.com/watchtower/blood-transfusions.php Watch Tower Bible and Tract Society of Pennsylvania. (2000, June 15). Questions From Readers — Watchtower ONLINE LIBRARY. Retrieved February 28, 2017, from http://wol.jw.org/en/wol/d/r1/lp-e/2004448 Watch Tower Bible and Tract Society of Pennsylvania . (2000, June 15). The Growing Demand for Bloodless Medicine and Surgery — Watchtower ONLINE LIBRARY. Retrieved February 28, 2017, from http://wol.jw.org/en/wol/d/r1/lp-e/102000003?q=closed%2Bcircuit&p=par