Anesthesiologists transfuse more blood than anyone 

Thanks for letting me know! As you can tell from the video, I wasn't aware of the role of Medical Laboratory Scientists and Medical Laboratory Technicians, but I am glad to know about their role and will look for an opportunity to swing by the blood bank!

@jdriggers you beat me to the exact comment. Fellow BB tech here. Mad respect back to you guys and anyone else here for working the trenches of that discipline. Max, thanks for giving some shout out to the transfusion world. We don’t look for the spotlight by any means but it’s nice to see people with your platform throwing some love our way. Any OR staff watching and reading these comments: have your pt type and screened BEFORE you take them to the OR (think at that preop appt weeks before the surgery while you’re drawing all the other preop labs). A nightmare scenario I’ve had in my career many times over is a brand new pt to us coming across my desk 25 mins before their surgery start time (or having the blood tube sent AFTER the team starts the surgery) and the screen portion of testing comes back positive. Or at the very least, check the pts blood bank record before you start cutting.

@maxfeinsteinmd Definitely ask for a tour of the blood bank, if the techs aren't in the middle of an MTP 😜 I'd be stoked to show you the fridges and analyzers and all the other equipment!

MLS here - Agreed, the OB hemorrhages are the scariest, worst ones. Had 2 of them on the same night!! during my first week as a baby lab tech fresh out of school. Fortunately I had two very experienced coworkers that helped me with everything.

I had to have a transfusion after my spinal surgery. My blood loss during surgery was minimal, but my labs and bp weren't at the level the surgeon wanted.

I had multiple blood transfusions during my 11.5 hour spinal fusion (T2-L2 with two disc prostheses placed) and they also used a cell saver throughout the surgery to collect as much of the blood I was losing as they could and then transfused it back to me. Also extremely grateful to the anaesthetist/anesthesiologist and all those who donated blood and continue to do so. 🙏🏻🙏🏻🙏🏻

Had 3 transfusions after 12 hour T10-S1 fusion due to chemistry issues. Only thing that got me upset were the costs, $3K a pop!! They get the blood for free, yes there are processing costs to spin the blood down and store it, but come on, really??

Thank you, and I hope your wife is doing well!

I, too, tell every physician I meet about you and your videos. They have all been very interested in hearing about you.

Thank you for pointing that out!

If you or anyone else are curious, the lab values can change significantly when the sample's transport is delayed, enough to produce erroneous results. we can add disclaimer comments to the lab report if the doctor still wants results.

Thank you for being a consistent blood donor!! It’s the consistent ones that really make a world of difference!!

Obstructive sleep apnea?

Heh I see what you did there.

That's a great idea, thank you!

@@MaxFeinsteinMDI’d like to see that as well. I donated two units of blood for my first two A/P lumbar fusions. A third was required in 2018 and I was surprised that no autologous donation was required. Although the doctor was very reluctant to go back into the area for a third time he called in a vascular specialist and it worked out well.

Just become a clown. Like a pro clown. You can get a free nose at Rite Aid on red nose day.

Thanks! I’ve been posting videos every couple weeks actually

@@MaxFeinsteinMD lol I'm currently feverishly going through them...

Ask the hospital for your own medical records. You may be able to access your records online too, depending on what charting program they use. they may or may not charge money for paper records.

they should have a full writeup of everything done in surgery, I got one for my resection

Yes. They also test every donation of blood for a variety of things.

Donors go through a screening process where they are asked many questions that involve drug use and sexual activity (types of lifestyle behaviors that increase risks of having hepatitis B, hep C, HIV) assuming the donor is honest in answering, most would not be allowed to donate due to the increased risk. Those that answer no to those types of questions would be allowed to donate but would still be tested for such diseases. Every single unit is tested as well. So even the if a person answers the questions the same every 8 weeks when they donate, every unit will still be tested for all of the same diseases, there is actually much more being tested than just those as well. There is always a very small chance of false negative testing though so there is always a small risk when receiving blood products. Medications are screened as well and many are OK such as cholesterol meds but other such as antibiotics to treat an infection would not be OK and would not be allowed to donate for a period of time. Also many medications that can cross the placenta and harm a fetus would not be allowed to donate either. There is a LOT that goes into the screening process both for the donor’s safety and the recipients as well! We really rely on the honesty and integrity of the donors to be honest and truthful to mitigate the risks to the recipient.

It is called spinal anaesthesia, it's a form of neuraxial anaesthesia where we inject local anaesthetic into the subarachnoid space to stop signals from being transmitted through the spinal cord.

@@BirdiesGoCherp I know that, but I was interested in the whole setup procedure. Turns out he had already done a video on epidural so I watched that. Really didn't help... I don't like the idea of purposely turning my back to be stabbed in the back a couple of times, but the benefits for post-OP pain management are just too great to refuse...

It honestly isn't that bad, I had it performed to me when I was getting my knee done. Just one prick was all it took, most of the time it just takes 1 jab and we're in.@@lillywho

Yes, every procedure we do comes with risks. For IV placement, risks in include infection and bleeding. With larger bore IVs, there can be a higher risk of causing vascular injury as well.

In some circumstances, patients can have some of their own blood stored weeks before the surgery so it can be transfused back to them during the actual surgery (their body would have regenerated that blood in the meantime). There are some other strategies along these lines, but overall if a patient refuses a blood transfusion, then I have a frank conversation that they may have an increased risk of dying from bleeding. Ultimately, I explain the risks, benefits, and alternatives to the anesthesia plan, and it's up to the patient to decide how they want to proceed.

Yes it is possible, but the patient must be minimum 110lb (~50kg) and 11g/dL hemoglobin. I have not seen this in practice at my own facility, it's all allogeneic (compatible donor).