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The transfusion of blood

Richard M. Titmuss

in The Gift Relationship: From Human Blood to Social Policy

This chapter discusses the transfusion of blood. Beliefs and attitudes concerning blood affect in varying degrees throughout the world the work of transfusion services in appealing for and recruiting ... More

This chapter discusses the transfusion of blood. Beliefs and attitudes concerning blood affect in varying degrees throughout the world the work of transfusion services in appealing for and recruiting blood donors. A deeply rooted and widely held superstition is that the blood contained in the body is an inviolable property and to take it away is sacrilege. In parts of Africa, for example, it is believed also that blood taken away cannot be reconstituted and that the individual will therefore be weakened, be made impotent, or be blinded for life. The growth of scientific knowledge about the circulation of the blood, the composition and preservation of blood, and the distribution of blood group genes throughout the human race has provided a more rational framework. However, it is only more recently that scientific advances have made a blood transfusion service an indispensable and increasingly vital part of modern medicine.Less

The Broken World of Transfusion

Jacob Copeman and Dwaipayan Banerjee

in Hematologies: The Political Life of Blood in India

This chapter is concerned with perceptions and campaigns concerning how doctors prescribe too much of that which has already been given. The proportions of the transfusion, say clinical activists and ... More

This chapter is concerned with perceptions and campaigns concerning how doctors prescribe too much of that which has already been given. The proportions of the transfusion, say clinical activists and others, are all wrong in Indian medicine. Once more, then, the focus is on proportionality and on educational campaigning, but here there is a different target. If donors do not give enough because they think they have a deficit when in fact (according to the campaign) they have a surplus, doctors prescribe blood as if they have a surplus when in fact they have a deficit. The irony is obvious: in so doing, of course, they exacerbate this deficit. Once more, excess is at stake, and the different spheres of excess interlock and inform one another.Less

The supply of blood in England and Wales and the United States

Richard M. Titmuss

in The Gift Relationship: From Human Blood to Social Policy

This chapter assesses the supply of blood in England and Wales and the United States. It presents the main national statistics in the increase in blood donation between the introduction of the ... More

This chapter assesses the supply of blood in England and Wales and the United States. It presents the main national statistics in the increase in blood donation between the introduction of the National Health Service in 1948 and 1968. Whereas in some countries at the end of the 1940s blood transfusion services were in an early stage of development, in England and Wales they had been expanded earlier. The effects of the Second World War, particularly the large quantities of blood required to deal adequately with the expected and actual civilian air raid casualties, greatly stimulated the growth of a blood transfusion service on a national scale. Unfortunately, it is not possible to present any series of statistics for the United States similar to those provided for England and Wales. It is not even possible to estimate with any degree of precision the total annual volume of blood collections, transfusions, and wastage.Less

Attitudes of Care

Duana Fullwiley

in The Enculturated Gene: Sickle Cell Health Politics and Biological Difference in West Africa

This chapter examines how Senegalese French-trained research-physicians in Dakar have adopted similar low-tech strategies and health interventions within the biomedical realm. It focuses on how ... More

This chapter examines how Senegalese French-trained research-physicians in Dakar have adopted similar low-tech strategies and health interventions within the biomedical realm. It focuses on how doctors rationalize economically triaged care, while chronicling their methods for doing so in Dakar's principal sickle cell clinics. These are the pediatric care site at Albert Royer Children's Hospital and the Centre nationale de transfusion sanguine (CNTS), or the National Blood Transfusion Center, where most adult patients are followed. Although physicians often take cues from the social realities that define their patients' lived experiences with this disease, their own clinical limits and technological constraints also inform the alternative assemblages of care they construct.Less

Is the gift a good one?

Richard M. Titmuss

in The Gift Relationship: From Human Blood to Social Policy

This chapter addresses the quality of the gift of blood. The transfusion and use of whole blood and certain blood products carries with it the risk of transmitting disease, particularly serum ... More

This chapter addresses the quality of the gift of blood. The transfusion and use of whole blood and certain blood products carries with it the risk of transmitting disease, particularly serum hepatitis, malaria, syphilis, and brucellosis. Not only are there risks in infected blood and plasma, but there are also risks in the use of contaminated needles and apparatus in the collection and transfusion processes. The absence of a scientific check on quality and safety means that the subsequent biological condition of those who receive blood constitutes the ultimate test of whether the virus was present in the donation. However, few patients know that their bodies perform this role. In these situations of consumer ignorance and uncertainty, as in many others in the whole field of medical care, the patient has to trust the medical profession and the organised system of medical care.Less

Transfusions: Ideas, People, and Places

in A Martian Stranded on Earth: Alexander Bogdanov, Blood Transfusions, and Proletarian Science

This chapter outlines the history of blood transfusions in Russia prior to the establishment of Alexander Bogdanov's institute. It examines the ways information about blood transfusions filtered into ... More

This chapter outlines the history of blood transfusions in Russia prior to the establishment of Alexander Bogdanov's institute. It examines the ways information about blood transfusions filtered into Russia and describes the particular dynamics of relationship between scientists and their patrons. This chapter discusses the discipline-building efforts of scientists and their patrons during the first years of the Soviet regime and identifies the factors that hampered institutional development blood science.Less

Blood Groups at War

Jenny Bangham

in Blood Relations: Transfusion and the Making of Human Genetics

When the Second World War began, Fisher’s lab was co-opted by the Medical Research Council, renamed the Galton Serum Unit, and tasked with providing practical support for the new Emergency Blood ... More

When the Second World War began, Fisher’s lab was co-opted by the Medical Research Council, renamed the Galton Serum Unit, and tasked with providing practical support for the new Emergency Blood Transfusion Service (EBTS). This chapter follows the Galton Serum Unit as it supported the new transfusion service, and made its wartime infrastructure serve genetic research. The EBTS—the establishment of which was driven in part by hematologist and depot director Janet Vaughan—comprised bottles, tubes, needles, sterilizers, refrigerators, transportation (crates and vans), institutions (the Post Office, blood depots, volunteer donor organizations, hospitals, and laboratories for blood processing and testing), and an extensive paper-based bureaucracy. A large cohort of clerks managed index cards, lists, letters, enrollment forms, donor cards, and labels, with which they managed people and blood. This chapter is about how blood-group research was shaped by these materials and networks, and how blood groups were negotiated between people with different interests. It is also a story about what can be done with paper—as scientists transformed the donor records of the transfusion services into the raw data of human inheritance.Less

The gift

Richard M. Titmuss

in The Gift Relationship: From Human Blood to Social Policy

This chapter looks at the nature of the gift of blood. The gift of blood has certain unique attributes which distinguish it from other forms of gift. The gift of blood takes place in impersonal ... More

This chapter looks at the nature of the gift of blood. The gift of blood has certain unique attributes which distinguish it from other forms of gift. The gift of blood takes place in impersonal situations, sometimes with physically hurtful consequences to the donor. Moreover, the recipient is in almost all cases not personally known to the donor; there can, therefore, be no personal expressions of gratitude or of other sentiments. If the principle of anonymity were generally abandoned, the consequences could be disastrous for givers and receivers as well as for all blood transfusion services. The chapter then presents a classification of the different types of blood donors: the paid donor; the professional donor; the pain-induced voluntary donor; the responsibility fee donor; the family credit donor; the captive voluntary donor; the fringe benefit voluntary donor; and the voluntary community donor.Less

Postwar Blood Grouping 1: The Blood Group Research Unit

Jenny Bangham

in Blood Relations: Transfusion and the Making of Human Genetics

When the war ended, the Galton Serum Unit was reconstituted at the Lister Institute in London. There, the Medical Research Council's Blood Group Research Unit, directed by serologist and geneticist ... More

When the war ended, the Galton Serum Unit was reconstituted at the Lister Institute in London. There, the Medical Research Council's Blood Group Research Unit, directed by serologist and geneticist Robert Race, was devoted to finding new blood groups and elucidating their genetics. Chapter 5 investigates the work of this lab, as it used the donors, samples, and regionally distributed infrastructure of the new peacetime National Blood Transfusion Service (NBTS) to study the serological properties and genetic inheritance of blood groups. Human blood had changed during the war: it was no longer simply an emergency treatment for shock, but was used in routine surgery, and during neonatal care. This chapter examines how the Research Unit used the regionally distributed NBTS, the NHS, and the bodies of donors and patients, to define new blood group variants and systems, and to turn blood into a more complex fluid, serologically and genetically. This is a story of postwar biomedicine built on relationships between laboratories, depots, hospitals, and public health authorities.Less

Postwar Blood Grouping 2: Arthur Mourant’s National and International Networks

Jenny Bangham

in Blood Relations: Transfusion and the Making of Human Genetics

The Lister Institute also housed the Medical Research Council's Blood Group Reference Laboratory, directed by Arthur Mourant. It carried out routine testing of puzzling blood samples, and distributed ... More

The Lister Institute also housed the Medical Research Council's Blood Group Reference Laboratory, directed by Arthur Mourant. It carried out routine testing of puzzling blood samples, and distributed standard blood grouping antisera nationally, to the British National Blood Transfusion Service (NBTS), and internationally, especially to labs associated with the World Health Organization (WHO). Mourant’s authority within the NBTS and the WHO put him in a position to engage in another project: to assemble large quantities of data on blood group population frequencies, in Britain and around the world. He oversaw a facility dedicated to the collection of such data, called the Nuffield Blood Group Centre, on the premises of the Royal Anthropological Institute in central London. This chapter examines how the movement of antisera and blood samples helped Mourant to channel blood group population data to this extensive data archive in London. It shows how these channels were shaped by wartime blood transfusion, by established colonial networks, and by new postwar infrastructures of international health. Coupling his standardization work to his paper-based “anthropological” collections meant that within a few years Mourant could claim to be in charge of the most authoritative collection of blood group genetic data in the world.Less

The characteristics of blood donors in England and Wales

Richard M. Titmuss

in The Gift Relationship: From Human Blood to Social Policy

This chapter explores the characteristics of blood donors in England and Wales, considering a study made in the summer and autumn of 1967 with the assistance of the Ministry of Health and the ... More

This chapter explores the characteristics of blood donors in England and Wales, considering a study made in the summer and autumn of 1967 with the assistance of the Ministry of Health and the National Blood Transfusion Service. The study examines regional trends and statistics relating to donor populations and donor reporting rates for the general public, institutions — comprising factories, offices, and universities — and the Defence Services. The general conclusion which emerges is that the donor sample broadly resembles the population in respect of age, sex, and marital status when account is taken of the possible effects of the age-incapacity and reproductive factors. Moreover, for most age groups, the general public donor is more representative of the national population than the institutional donor or the total of all donors. The institutional and Defence Services donor tends on the whole to be younger.Less

A study of blood donor motivation in South Africa

Richard M. Titmuss

in The Gift Relationship: From Human Blood to Social Policy

This chapter looks at a study of blood donor motivation in South Africa, which was commissioned by the Natal Blood Transfusion Service and carried out in Durban. Much of the fieldwork was done by six ... More

This chapter looks at a study of blood donor motivation in South Africa, which was commissioned by the Natal Blood Transfusion Service and carried out in Durban. Much of the fieldwork was done by six trained Bantu graduates which helps to explain the perceptive nature of some of the interview data elicited from poor and semi-literate Bantu workers. The study shows that the Bantu donor is statistically rare. They come mainly from institutional groups such as factories and schools and tend to be younger, better educated, and with higher incomes than the average Bantu adult in Durban. The concepts of blood held by the average manual worker Bantu closely link blood with health and are unfavourable to blood donation. Moreover, in the Bantu population at large there is widespread ignorance about, and fear of, blood donation. A marked characteristic of the Bantu blood donors is that they tend to give blood only once or twice.Less

Blood in the Time of the Civic

Jacob Copeman and Dwaipayan Banerjee

in Hematologies: The Political Life of Blood in India

This chapter focuses on blood in the time of the civic—that is, blood that is donated voluntarily as a dutiful contribution to civic life, that in turn ensures the continued efficacy and productivity ... More

This chapter focuses on blood in the time of the civic—that is, blood that is donated voluntarily as a dutiful contribution to civic life, that in turn ensures the continued efficacy and productivity of transfusion medicine. These voluntary donations take place according to a seemingly simple biological time map: the biological time of cellular production determines the biomedically mandated three-month gap between donations. The time regime of the repeated voluntary donation emerges from and is mapped upon the lifetime of blood cells. This is in contrast to apparently less civic-minded blood donation modes: the potentially dangerous commercial transaction of paid blood donation and the one-time mode of “replacement” donation, performed in order to release blood for the benefit of one's immediate family member in need of transfusion. As this chapter shows, these modes of donation are characterized by different temporalities. A routine of dutiful repetitive bloodshed structures voluntary blood donation's time of the civic.Less

The demand for blood in England and Wales and the United States

Richard M. Titmuss

in The Gift Relationship: From Human Blood to Social Policy

This chapter examines the demand for blood in England and Wales and the United States. Between 1948 and 1967, the annual number of donations of blood in England and Wales rose by 269 per cent. Some ... More

This chapter examines the demand for blood in England and Wales and the United States. Between 1948 and 1967, the annual number of donations of blood in England and Wales rose by 269 per cent. Some part of this increase in supply has met the increase in the amount of blood actually demanded and used per 100 patients treated in hospitals. Meanwhile, estimates have been made that 5,100,000 pints of blood were collected in the United States in 1956 and around 6,000,000 pints in 1966–7. Some of the factors responsible for this world trend relate to the major life-saving role of blood. Others are adding yearly to the relatively new role for human blood of acting as a vital preventive and therapeutic agent. Surgery in its many branches has, for example, been given a new lease of life by increases in the volume of blood available and the advent of effective blood transfusion services.Less

The significance and management of anaemia in palliative care patients

Wale Atoyebi, Tim Littlewood, and Robert Twycross

in Palliative Care Consultations in Haemato-oncology

This chapter reviews the background, investigation, causes, and management of anaemia in palliative care setting. Anaemia is a common complication of cancer and cancer therapies, occuring in 50 per ... More

This chapter reviews the background, investigation, causes, and management of anaemia in palliative care setting. Anaemia is a common complication of cancer and cancer therapies, occuring in 50 per cent of patients with solid tumours and in patients with disorders such as myeloma and lymphoma. It induces symptoms such as fatigue, weakness, and dyspnoea. In the palliative setting, the approach for managing anaemia is still based on the estimations from studies published in the last ten years in cancer patients receiving oncological treatment when treated with anaemia. Managing anaemia consists of two approaches: blood transfusion and recombinant erythropoietin (rHuEPO). In the chapter, the benefits and limitations of these management strategies are presented, including case studies demonstrating how patients respond to such treatments.Less

Cardiovascular system

Michelle Green and Kirsten Huby

in Clinical Skills in Children's Nursing

This chapter will outline the anatomy and physiology of the cardiovascular system and the changes that occur during childhood as this body system matures. Signs and symptoms of cardiovascular ... More

This chapter will outline the anatomy and physiology of the cardiovascular system and the changes that occur during childhood as this body system matures. Signs and symptoms of cardiovascular failure and nursing assessment and monitoring of the child will also be discussed. This knowledge will enable the nurse to recognize cardiovascular failure as early as possible and commence appropriate interventions. A range of interventions and clinical skills required for cardiovascular support are also explained, utilizing evidence-based guidelines. All aspects of care will be discussed using a family centred and child-friendly approach. The Nursing and Midwifery Council (NMC) introduced the use of essential skills clusters (ESC) to help pre-registration nursing students meet the standards of proficiency required for registration (NMC, 2007b). They are written from the perspective of what the public can expect of a newly qualified nurse and are designed to improve safe and effective practice. The information contained within this chapter covers aspects of most of the skills clusters. In particular, the underpinning principles from: care, compassion, and communication (1); organizational aspects of care (9, 10); infection prevention and control (22, 25, and 26); and nutrition and fluid management (29, 32) which are integrated throughout the discussion. At the end of this chapter you will: ● Understand the anatomy and physiology of the cardiovascular system and the changes that occur during childhood as this body system matures. ● Learn to recognize signs and symptoms of cardiovascular failure. ● Be familiar with nursing assessment and cardiovascular monitoring of the child. ● Understand how the nurse recognizes cardiovascular failure as early as possible and commences appropriate interventions. ● Begin to develop an understanding of the range of interventions and clinical skills required for cardiovascular support. The cardiovascular system is vital for supplying the tissues of the body with blood. This blood supply enables the needs of individual cells for oxygen and nutrients and removal of waste products to be met (metabolic demands). The body is also able to achieve these functions under a variety of circumstances: at rest or sleeping; during exertion through exercise; and during the extra demands placed on the body as a result of illness. Less

Negotiating the boundaries of nursing practice

Jane Brooks

in Negotiating nursing: British Army sisters and soldiers in the Second World War

The chapter examines the changes to the dominion of nursing work on active service overseas. The chapter first explores the extensions to the nursing role, most particularly the care of wounds and ... More

The chapter examines the changes to the dominion of nursing work on active service overseas. The chapter first explores the extensions to the nursing role, most particularly the care of wounds and burns. This is followed by a discussion of the expansion of nursing duties into those that had hitherto been the domain of medicine. These roles include the commencement and management of blood transfusions, surgical work and anaesthesia. Finally the chapter considers ‘new work’, the most critical of which was the administration and use of penicillin. The constantly shifting requirements of war nursing prevented Army nurses from remaining in a professional comfort zone of accepted roles and regimes. The experience of living with uncertainty may have caused anxieties for some, but the active participation in new treatment modalities suggests that nurses who went to war were keen to move beyond the normal boundaries of nursing practice and many relished the opportunity to do so. The chapter argues that the developments in practice and the increased confidence nursing sisters displayed with this new work altered their working relationships with medical officers from one of deference to one of collegiality, enabling more productive decisions for their soldier-patients’ care.Less

Hepatitis Viruses: Oysters, Blood Transfusions, and Cancer

Michael B. A. Oldstone

in Viruses, Plagues, and History: Past, Present, and Future

This chapter studies the history of hepatitis virus infection. Hepatitis and/or jaundice were recorded in the fourth century BC by Hippocrates and over 1,000 years ago in the ancient Chinese ... More

This chapter studies the history of hepatitis virus infection. Hepatitis and/or jaundice were recorded in the fourth century BC by Hippocrates and over 1,000 years ago in the ancient Chinese literature. By the end of the nineteenth century and early twentieth century, the association of a virus infection with jaundice and liver disease was made. The major hepatitis viruses are hepatitis A (HAV), hepatitis B (HBV), and non-A, non-B or hepatitis C (HCV). HAV is transmitted almost always by fecal–oral routes but occasionally by transfusion or inoculation of blood obtained during the transient stage of viremia that occurs during the HAV incubation period. While there is currently no effective vaccine for HCV, an effective vaccine exists for HBV. A problem with the HBV vaccine is individuals refusing to be vaccinated. Nevertheless, recent progress made on the understanding and treatment of these viruses has led to the World Health Organization planning that by 2030 hepatitis infections will be reduced by 90% and deaths by 65%.Less