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Caleb Meza

on 11 September 2014

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History of
Blood Transfusions
British physician William Harvey discovered the circulation of blood in 1628.
First ever successful blood transfusion between two dogs in 1665.
In 1667 the first ever transfusion between sheep and man successful.
Animal Blood
Human Blood
Medical Advancement
Blood Transfusion
By: Luis Gutierrez, Caleb Meza, and Brandon

Working at the Royal society
in 1660's Richard Lower began to test the blood volume and circulation on animals.

One of the pioneering cases for successful blood transfusion between animal and human was performed by Dr. Jean-Baptiste Denys on a 15 year old boy, who later on died because Dr. Jean-Baptiste operated on the same patient with more blood and the boy had an allergic reaction
British obstetrician James Blundell performed the first successful transfusion of human blood to a patient for the treatment of postpartum hemorrhage.
Before a blood transfusion is given, there are many steps taken to ensure quality of the blood products like compatibility, and safety to the recipient/receiving patient.
What did medicine look like prior to your medical advancement?
What was the scientific process for this
What necessitated the creation and use of this medical advancement?
What impact did the war(s) have on
the medical advancement?
What governmental policies and controls were
involved with your medical advancement?
What were the ethical questions that arose due to the advancement?

In what ways did this advancement bring about equality or inequality?
What does this medical advancement look like
today and how is it used today?

Prior to World War l blood transfusion were impractical and dangerous; doctors
had no access to anticoagulants, blood typing did not exist, and blood banks were not even a concept. After it's discovery it was not put into medicinal use for a long period of time because it was unpredictable(some people survived others died), techniques were more or less ineffective, and blood was hard to obtain.

What necessitated the advancements in blood transfusion is the need for a surplus in
blood that was practical and healthy, so the soldiers in WW1 can survive blood fatal wounds. The first primitive form of blood transfusion were used primarily for scientific research, and was later deemed impractical. During the war nurses and doctors were forced to obtain blood as casualties arrived. So time is wasted retrieving the blood instead of inserting it into the victim, resulting in many death due to blood loss. Many times while trying to perform a blood transfusion procedure the blood will begin to coagulate rendering the blood useless. Even when the blood was successfully injected into the patient sometimes they would die unexpectedly. The patient had an allergic reaction to the blood, because no one knew blood was different and had different groups.

The impact that WW1 had on blood transfusion is again the need for a surplus in blood that was practical and healthy, so the soldiers can survive blood lose. For soldiers in WW1 blood was needed at a moments notice, and the early stages of blood transfusion were difficult to perform and impractical. It was Capt. Oswald H. Robertson who introduced the use of preserved blood in casualty clearing hospitals. He reasoned that blood was needed as casualties arrived, so the blood must be preserved and stored for when needed instead of obtaining in the moment of crisis. So the use of anticoagulants was introduced to blood transfusions.

The government policies and controls that were involved with blood transfusions are screening questions that help, the clinician determine if the donor is good to donate blood. If the donor is eligible the blood is tested for the bloody type and the Rh type. After determining the blood type, the blood is tested for certain proteins, so the proteins won't affect the person that is obtaining the blood transfusion.

There were three contributions to the process of Blood Transfusion during WW1 that made it the reliable and practical process it is today. Those include Blood Banks, Blood Typing, and Anticoagulants.
Blood Banks
Blood Types
Blood typing was discovered in 1901 by Austin Karl Landsteiner. He discovered the most important aspect to blood typing; the ABO grouping. While at the University of Vienna, Landsteiner was trying to discover why some people died due to blood transfusion and some were saved. This discovery helped doctors find the properties of anti-A and anti-B and antigens within the blood cells. Which is the reason some blood types don’t work well with each other, because the antibodies fight off specific antigens.
The anticoagulant effects of heparin were discovered by chance by Mclean in 1915, when he was searching for pro coagulants(causes coagulation) in dog livers. Heparin is a naturally occurring anticoagulant within basophils(white blood cells) and mast cells(connective tissue). They work at breaking down clots that have already formed. This medication today is one of the World Health Organization’s List of Essential Medicines.
When Blood transfusion was first being done and developed there wasn't as much steps as there is now. Take for example blood type, back when the first successfully blood transfusion was done, they did not ask the person/patient what blood type they where because they still had little to no knowledge on the fact. But now patients are asked for their blood type in order to make a mutual blood transmission (where the patient's body does not reject the transmitted blood). Not only is this step taken now, but many more as well like; inform consent, IV catheter correct placement, etc. Blood must now be stored in the right environments with the right chemicals to prevent coagulation.
When blood transfusion first began many question arose about this medical advancement such as; Is it correct/right to take blood away from a healthy host to give to the sick? and, Is it correct to play with a humans life? Especially during WW1 when soldiers were coming into Hospitals with wounds. The question was should we take liters of blood out of a healthy soldier(who were the only donors available), to save the life of a soldier close to dieing.
Blood transfusion now can be given to anyone who needs it and qualifies, a major problem lies within the blood types. If you are in need of blood you blood type can prevent or lengthen the time it would take to obtain your blood donation. For example one of the more rare blood types in O-, and O- blood can only receive blood from other O-, so finding a donor with the same type would be much more difficult where as those of AB+ blood can receive from all blood types of all Rh types.
During WW1 the first attempt to store separated red blood cells was done in iced bottles. The very first blood donor service was established in 1921 by the British Red Cross. Donors were subjected to physical tests to establish blood groups of individuals. One of the earliest blood bank was established by Federico Duran. During the Spanish Civil War Federico was working at the Barcelona Hospital, where wounded soldiers entered the hospital daily, there he discovered that even with the donated blood they could not keep up with demand. He and the Department of Health decided to take the 300-400 ml of blood and mix it with 10% sodium citrate solution. The blood was stored in sterile glasses, and during the 30 days of use the hospital registered 9,000 liters of blood.

Direct Transfusion
The use of direct transfusion was used quite extensively. The procedure itself was to attach a tube from one person to another and directly move the blood from one person to another. This technique was not sensible seeing as how men were being dragged into hospital encampments nearly dead, and finding someone willing to donate was time consuming. The variables involved were also extensive.
Another technique was the Kimpton-Brown technique. The procedure had a donor insert a tube in their vein and send the blood into a graduated glass cylinder. The cylinder is then closed with a plug with a tube inserted in the middle and a pump on the side to create an air locked container. The doctor would then squeeze the pump to send the blood up the tube and into the patient. Blood would of course coagulate and create blood clots.
Another technique was called the syringe-cannula technique. It reasoned that if you take the blood directly from the body using a syringe and quickly insert it into the patient it would not allow for the blood to coagulate in time. Firstly it didn't allow for enough blood to be extracted at a single given moment and secondly it just wasn't a technique that was affective.
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