A tale of two patients Louise Phillips Presentation at TORC 2011 Annual Seminar Perioperative...
-
Upload
jared-pearson -
Category
Documents
-
view
216 -
download
0
Transcript of A tale of two patients Louise Phillips Presentation at TORC 2011 Annual Seminar Perioperative...
A tale of two patients
Louise Phillips
Presentation at TORC 2011 Annual SeminarPerioperative Patient Blood Management
Patient 1:43 y.o. Female
Diagnosed with Colorectal Cancer, Stage IIIB
Otherwise healthy
At Diagnosis: Hb 114
TRF 6TRF Sat 8Ferritin 5
8 Days LaterAt Surgery: Hb 108
18-Feb-10
20-Feb-10
22-Feb-10
24-Feb-10
26-Feb-10
28-Feb-10
02-Mar-
10
04-Mar-
100
20
40
60
80
100
120
Haemoglobin
SURGERY
TRANSFUSION2 UNITS RBC
Patient 2:43 y.o. Female
Diagnosed with Colorectal Cancer, Stage IIIB
Otherwise healthy
One significant difference.......
At Diagnosis: Hb 114
TRF 6TRF Sat 8Ferritin 5
Requested (and received)Iron Infusion
8 Days LaterAt Surgery: Hb 129
18-Feb-10
20-Feb-10
22-Feb-10
24-Feb-10
26-Feb-10
28-Feb-10
02-Mar-1
0
04-Mar-1
00
20
40
60
80
100
120
140
Haemog
lobin
SURGERY
FE INFUSION
18-Feb-10
20-Feb-10
22-Feb-10
24-Feb-10
26-Feb-10
28-Feb-10
02-Mar-1
0
04-Mar-1
00
20
40
60
80
100
120
140
Patient 2Patient 1
Haemog
lobin
SURGERY
FE INFUSIONFOR PATIENT 2
TRANSFUSIONPATIENT 1
18-Feb-10
20-Feb-10
22-Feb-10
24-Feb-10
26-Feb-10
28-Feb-10
02-Mar-1
0
04-Mar-1
00
20
40
60
80
100
120
140
Patient 2Patient 1
Haemog
lobin
SURGERY
FE INFUSIONFOR PATIENT 2
TRANSFUSIONPATIENT 1
Three Phases of Patient Blood Management
Patient 1 Patient 2
As a patient• I want (expect) the best care possible• I need to believe I am going to get it• I am prepared to be involved in the decision makingbut...• I (like you) am unusual in my level of knowledge
Interaction between Doctor and Patient
Doctor
Patient
Meaningful Exchange of InformationDiscussion of the optionsShared Decision Making
Thanks to....
• My Medical Team– Dr David Slonim, Mr Martin Chin,
Dr Malcolm Cunningham, Dr Ian Haines
• Help with the presentation– Prof James Isbister– Dr Zoe McQuilten