Blood Management


Blood Management

Swedish Blood Management provides key services to:

  • Reduce patient exposure to blood transfusion (blood conservation)
  • Achieve safe blood management practices
  • Optimize blood utilization
  • Reduce variations in transfusion practice
  • Support a patient’s decision to minimize or eliminate the use of blood or blood products

Swedish recognizes blood management as a priority in health care because of:

  • Increased public demand for safe alternatives to blood transfusion therapy
  • Growing numbers of patients who request medical services without the use of blood
  • Advanced technology and pharmacological agents which make bloodless medicine and surgery not only possible but preferable
  • Decreased national blood supply
  • Escalating costs due to the growing number of federally mandated tests to screen donated blood for disease

Anemia is a below-normal level of hemoglobin in the blood. That means that the blood cannot deliver enough oxygen to the rest of the body, causing fatigue and other symptoms. The most common form of anemia is iron deficiency anemia.

Anemia is the primary reason patients receive a blood transfusion. Preventing, detecting and treating anemia are the most important factors to avoid the need for a blood transfusion and maintain optimum health.

What you can do
  • Be alert to signs or symptoms of anemia. Ask your doctor to check your blood count. If your doctor says you are anemic, talk to your doctor about how you can increase your blood count.
  • Before you have surgery or give birth, ask your provider about an anemia consult through Anemia Clinic at Swedish. This consult is performed by a pharmacist and assesses if you need to be treated for anemia. This key service is a proactive approach to avoiding blood transfusions.
    • It is best to complete this 30 days before surgery, or as early in pregnancy as possible so that any treatment recommended for you will be most effective.
    • The information from the consult is sent to your doctor so a treatment plan tailored to your needs can be developed. Treatments include oral or intravenous medications, nutritional counseling, and/or vitamins.
  • If you are over the age of 50, be sure to get a regular colon screening. This diagnostic procedure is helpful to determine if you have internal bleeding or cancer that may be causing anemia.

The Swedish Bloodless Program offers a team approach to health care that eliminates the use of blood transfusions, even in a life-threatening situation.

Who should access the Bloodless Program?

The Bloodless Program meets the needs of patients who resolutely object to the use of blood or blood components, even in a life-threatening situation, whether this refusal is based on religious, personal or other reasons.

When and how do I register for the Bloodless Program?

Complete one of the following refusal forms and contact the Bloodless Program as early as possible during treatment. This free service is available to any Swedish patient.

Next steps:

  • You’ll participate in a brief patient interview by phone or in person.
  • We’ll ask you to fill out the Refusal of Blood Products form which documents your refusal of whole blood and the four primary components (red cells, white cells, platelets and plasma), as well as your choices regarding minor blood fractions and medical procedures or treatments involving the use of your blood.
  • The form will be scanned into your Swedish electronic medical record.
  • If you have a Durable Power of Attorney for Health Care (DPA), it may also be scanned into your chart as part of your enrollment process.
  • You may update your enrollment at any time.

Swedish Blood Management hosts events throughout the year that align with our mission to be a leader in blood management.

Bloodless program workshop

This virtual workshop is for those who want to document absolute refusal of blood transfusion. The discussion covers an overview of blood components, minor fractions of blood and procedures involving a patient’s blood.

Call 425-490-4244 or email for more information.

There is no substitute for blood. However, several strategies used individually or together have proven effective to overcome the need for a blood transfusion in many situations. These include medicines, techniques and devices that minimize blood loss and maximize blood volume.

Before Surgery

  • Anemia management
  • Minimal blood draws

During Surgery

  • Anesthesia techniques
  • Cell salvage
  • Electrocautery
  • Hemodilution
  • Hemostatic drug therapy
  • Meticulous surgical techniques
  • Minimally invasive surgery such as the CyberKnife, aneurysm microsurgery (coiling), and the da Vinci robotic surgery technology
  • Tissue adhesives and sealants
  • Volume expanders

After Surgery

  • Anemia management
  • Appropriate fluid administration
  • Cell salvage
  • Minimal blood draws
  • Monitor and arrest bleeding
  • Reduce oxygen consumption

Non-Surgical Patients

  • Appropriate oxygen administration
  • Blood cell stimulating drugs
  • Hemostatic drug therapy
  • Minimal blood draws
  • Nutritional support
  • Reduce oxygen consumption (rest)

Tell your doctor about any medications, nutritional supplements or herbs you take. Many of them can cause bleeding or other serious complications – including stroke, heart failure, seizure and coma – during surgery. These supplements include garlic, ginger, ginseng, feverfew, flax seed, fish oil, dong quai, kava, licorice, saw palmetto, St. John's wort, omega 3, valerian and others.

In the hospital, talk to your child’s nurse or doctor as soon as possible to let them know your wishes. It is important to keep the lines of communication open to avoid a blood transfusion.

Patients under 18 years of age may be enrolled in the Pediatric Bloodless Program. Please contact Blood Management for more information or a referral to a participating physician.

You must follow the instructions for completing your Advance Directive/Durable Power of Attorney for Health Care in accordance with the laws of your state.

In an emergency where you are unconscious and there is no advance directive/DPA, emergency personnel could be faced with the responsibility to administer a blood transfusion. Therefore, please fill out and always carry your DPA with you. 

If you are planning a surgery or procedure at Swedish Medical Center, you may contact Blood Management to complete the “Refusal of Blood Products” form. Your choices will be documented at Swedish Medical Center. However, enrollment in the Bloodless Program at Swedish Medical Center does not take the place of a DPA.

Routine medical care can quickly develop into a situation that requires immediate and specialized treatment. Swedish is equipped to employ the strategies that make bloodless medicine and surgery possible. When you are enrolled in the Bloodless Program, the health care team can quickly care for you without blood transfusion. Each member of the hospital team knows their role in managing your care without the use of blood, whether they are the anesthesiologist, pharmacist, surgeon or admitting clerk. The net result is greater safety, quality care and respect for you.