Summary
Summary Medicine Haematology (SCMD3000)
- Course
- Medicine (SCMD3000)
- Institution
- University Of The Witwatersrand (wits)
Summary of lectures from haematology block
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Haematology BlockSection 1 Summary
Chaandanee Bhayroo
1420214
GEMP 1
,Public Health Introduction to Haematological Diseases
Haematology is the study of blood, blood-forming organs, and blood disorders - diseases of the
blood and blood components
Haematological diseases belong largely to group of conditions referred to as non-communicable
diseases (NCD)
ICD-11
III Diseases of the blood and blood-forming organs and certain disorders involving the
immune mechanism
Contributes greatly to the global burden of disease
All diseases have a haematological component
Determinants of Haematological diseases
Non-modifiable Behavioural Physiological
Age Immunocompromised Deficiency (nutritional)
Sex - cancer Infections
Genetic - HIV Toxins
- TB Medication (poly-pharm/cross
use)
Levels of Prevention
Primordial Primary Secondary Tertiary
Social Susceptible Asymptomatic Symptomatic
Other Health promotion Screening Treatment
- diet - haemoglobin
- exercise - WBC
- alcohol - platelet
- tobacco - peripheral blood
smear
- cellular morphology
Folate Safe adequate blood Adherence
supply
Rehabilitation
Primary should be of the focus for preventions strategies
South African National Blood Service
● Non-profit organisation
● Provides sufficient, safe, quality blood products
● Medical services related to blood transfusion
● Clinical services, specialized services, proficiency testing
● Rated amongst the best services in the world
● Research and training provided
, ● Excludes Western Cape
● Demand:
o Cancer patients
o Childbirth
o Emergency situations
● Shortages occur most often during school holidays
o Lower collections of blood as a result of schools and universities closing
o Demand staying consistent
● Current blood stock = days
● Current platelet stock = 0.3 days
Minimum Requirements to be a Blood Donor
, IV Cannulation
Indications Contraindications
Fluid resuscitation & rehydration Patient refusal
Electrolyte replacement Sepsis, injury or burn at the site of cannulation
Surgery (anaesthetic) Clinical inexperience
IV medication (chemotherapy) Motor/sensory deficits
Blood products Arteriovenous fistula
IV contrast
Central line Peripheral line
Long-term (ICU, GI surgery) Safer
Direct access for sclerosing agents and Easier to obtain
medications that cause harm if extravasated
Difficult IV access – severe dehydration, IV drug Less painful
user
Surrounded by arteries and nerves which can be Direct compression of puncture site
damaged, may cause pneumo/haemothorax
Difficulty and Failure
● Obesity
● Wasting
● Prolonged hospitalisation
● Vasculopathy
● CT disease
Ensure veins are palpable and visible. Optimise conditions
Peripheral Venous Catheters
● Choose smallest needle
possible for patient comfort
and lesser complications
(smaller thrombophlebitis
since less damage to
endothelium =more flow
around cannula)
● Emergency – use largest
catheter available
● Need to make sure your first attempt is your best attempt since peripheral shut down is very
common
● Antecubital fossa = larger lumen & can accommodate higher rates of fluid flow during
resuscitation = have to stabilize elbow to minimize movement & remain visible
● External jugular vein = put patient in Trendelenburg position with head down & stabilize
skin!
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