How critical patient Sam’s own blood saved the day

LAST week, I started to tell you what happened to Sam who, many years ago, was quite literally run over by a bus.

It wasn’t the most sensible thing Sam had ever done – but finding that parked vehicle and lying under it to shade himself from the sun seemed like a good idea.

Until, that is, the time came for the school run and it suddenly moved off, rolling a big, black wheel right over his abdomen.

Who knows what damage could have been done to his fragile and friable organs?

When he was brought to the surgery, he was sore and pale. It was pretty obvious he was bleeding internally but, with no blood donor for miles and blood storage still in its infancy, it didn’t look good for him at all.

As his gums paled and his respiratory rate increased, it looked like his life was painfully ebbing away.

By the look in his eye, it seemed like he knew it too. Because, as I quoted last week: “You can’t get blood out of a stone.” Or can you?

Autologous blood transfusion (ABT) is possible when the patient’s own blood is collected from an actively bleeding site, filtered and then transfused back into the patient through a giving set and cannula inserted into a vein.

The process offers some significant advantages over conventional blood donation.

By definition, the donor and recipient are identical, so adverse reactions are unusual.

The blood, of course, is readily available and, hey, it is already at body temperature, so no need for warming, which takes time and can damage cells.

Add to that the elimination for blood typing and the risk of transferring diseases, along with a reduced cost to the owner, and you might wonder why we don’t do it all the time.

Well, we do. But only when the circumstances are right.

Collecting blood from a ruptured tumour, for example, and injecting it back into the blood stream isn’t always in their best interests. But Sam was lucky. No time was wasted in administering a careful general anaesthetic.

Exploratory laparotomy revealed, as expected, an abdomen full of blood.

As two nurses aseptically syringed the life-saving fluid out over and over again into a transfusion collection bag, the surgeon identified the tear in Sam’s spleen.

As the spleen was clamped and removed, Sam’s own blood flowed back through his veins, pushing his blood pressure back up, carrying oxygen to his vital organs and turning the tide back in favour of life.

He lived for many years after.