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blood bag collection
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Eric Blake
Message 1 of 7 , Aug 6 2:38 PM 
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I have a polycythemia patient that needs occasional bleeding.  It is a recent diagnosis and we are still getting a feel for the frequency.  The oncologist I referred her to was not 'personable' so the patient doesnt want to go back, and the red cross botched her veins, so she wants us to do it.  
We are talking to our medical product supplier about getting a blood bag setup. 

My question is for those who have dealt with this - option A is to dispose in the biohazard or option B would be to donate it somewhere. Has anyone dealt with routine blood disposal?


Rick Marinelli
Message 2 of 7 , Aug 7 6:20 AM 
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Hi Eric,

Years ago when I had a patient contact me and wanted me to "bleed" them for their chronic hep c, mostly because he wasn't that successful at getting more than 100ml or so doing it himself. I was dubious about this until I did a literature search, saw that it was not only legit, but a wonderful therapy in itself. After finding the studies I contacted the Director of Portland RC and he was excited, too, to see that phlebotomy was an effective therapy in and of itself for some patients for chronic hep c (in addition to PV, hemochromatosis, etc.).

Why am I telling you all this? The patient had been disposing his blood in the toilet. When I asked the medical director about this, he said it was legal and the preferable method of blood disposal!  I always tried to send folks to the RC which worked for most but some patients wanted me to do it. 

This is the method I came up with: terumo brand blood collection bags (heparinized tubes/bag so no premature clotting, have to buy a case). These are 500 ml and you can eye the volume pretty well if you want to take less. Take a large emesis basin and place the blood bag in that on the floor (need gravity assist). Start the collection (no sloppy blood draws here, its a large needle) and observe. Generally 500ml in 5-7'. Stop collection and dispose of bag in toilet after cutting the end and letting it drain in the toilet. With hep c patients, I did this at my clinic so not expose my staff to the higher risk (splashing if you're not careful). With polycythemia or hemochromatosis, of course, one is at less risk.

Dr. Lance Trainor was the Dir. that I talked with and said this was a good method for diy.

HTH,

Rick Marinelli, ND
Portland, Oregon


Eric Blake
Message 3 of 7 , Aug 7 10:24 AM 
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HI Rick
My wife had suggested just that - she has worked in the OR as a surgical assistant for about 10 years and that is exactly what they do.  Honestly my concern with that had to do with having my staff do that and wondering if that was standard medical procedure.  With two opinions I can trust now I think that will be our plan. 
 
best
Eric


Heidi Peterson
Message 4 of 7 , Aug 7 1:05 PM 
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You can prescribe therapeutic phlebotomy at the red cross.  It is free.  Call them and they will send you an order form. 


Eric Blake
Message 5 of 7 , Aug 25 12:41 PM 
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Here is a reply re: blood bag / donation etc on the list from Dr. Marinelli a few years ago


Mona Morstein
Message 6 of 7 , Aug 25 4:52 PM 
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Just to let everyone know, more recent research on phlebotomy for elevated ferritin (NAFLD, NASH, etc) has been shown to NOT be effective as a liver protectant or treatment. The recommendation now is to not do phlebotomy with that intent. 

http://www.ncbi.nlm.nih.gov/pubmed/25524401

Also, this was a great study showing that actually, although ferritin is oftentimes elevated in NAFLD/NASH patients, it does not actually seem to be related to inflammation, but simply to increased iron storage: http://www.annalsofhepatology.com/revista/numeros/2014/07_143_v13n3_2014_InflammationCause.pdf

Mona Morstein, ND, DHANP
Tempe, AZ


Emily Kane
Message 7 of 7 , Aug 25 5:49 PM 
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I have heard recently that one reason that women live longer than men is because of monthly menstruation, which is not only a "cleansing" event, but also stimulates hematopoiesis and that both women and men after a certain age can benefit from bi-annual phlebotomy.
Cheers
EMily Kane ND
Juneau AK