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Presurgical Anemia Program Makes Surgery Safer

Karen Randall, Sherri Ozawa, Christina DeMarco, and Dr. Jill Morrison

The Englewood Hospital and Medical Center presurgical anemia program addresses the needs of patients with low levels of red blood cells before they undergo surgery. As a result, patients experience safer, more effective procedures with a lower risk of complications.

On a day-to-day basis, red blood cells are responsible for transporting oxygen through the body, keeping tissue alive, and promoting healing. When someone has surgery, those cells become even more important to keeping him or her well, especially if bloodless procedures are performed.

According to the National Heart, Lung, and Blood Institute, more than 3 million people have anemia—low levels of red blood cells in circulation or when red blood cells don’t function properly. “Anemia is a symptom of an underlying issue that needs to be addressed before patients undergo certain treatments or procedures,” says Sherri Ozawa, RN, clinical director of the medical center’s Institute for Patient Blood Management and Bloodless Medicine and Surgery. “That’s why we’ve established the presurgical anemia screening program—to identify and correct these problems and give patients the best possible opportunity to thrive with treatment.”

Streamlining anemia care
At Englewood Hospital, anemia screening is offered as part of standard presurgical testing, with a special focus on screening orthopedic and cardiovascular surgery candidates. Patients work hand-in-hand with Karen Randall, APN, a nurse practitioner with the anesthesiology team, to find out where they stand.

“I order tests that check the blood for levels of a specific protein called hemoglobin, which is responsible for carrying oxygen,” Randall says. “In women, if that hemoglobin level is lower than 12 grams per 100 milliliters, or if it’s lower than 13 in men, then we know that patient needs to receive additional care before being cleared for surgery.”

Targeted treatment
Once anemia is diagnosed, additional tests are used to reveal the precise reason for low red blood cell levels. In some patients, that may be a deficiency in certain nutrients, such as vitamin B12 or iron, while in others, internal bleeding or pre-existing medical conditions may be the cause. Even certain treatments or medications, such as chemotherapy, can cause anemia. Anemia is treated at Englewood Hospital’s leading-edge Infusion Center with a variety of therapies such as intravenous iron repletion or iron infusion, bone marrow stimulating injections, and supplemental B12 and folate.

“Patients and doctors all understand the importance of being in the best possible health before having surgery,” says Christina DeMarco, APN, administrative and clinical director of the Infusion Center. “Just like we would want to address conditions such as high blood pressure prior to anything physically taxing, anemia is a common medical condition that needs to be addressed.”

“It takes a week for the body to create a red blood cell,” says Jill Morrison, MD, hematologist and oncologist with Englewood Hospital. “That’s why it is so important for doctors to refer patients to us for screening and care. The sooner we identify patients with anemia and begin care, the better prepared they can be for surgery.”

Posted on June 14, 2016