Dr. Aryeh Shander - in an interview on PBS -' Blood Test: What you don't know about blood ' special from Aug 2010 was asked a similar question - Interviewer "At what point must you transfuse?"
Dr. Shander's reply " That is a hard question for me to answer. We have had patients go home who's blood count was below 2 gm/dl" " Interviewer "Without blood?
Dr. Shander "Without blood!" and he had a big smile on his face. One Patient came from another NJ hospital which tried to stop patient's transfer to Englewood-even to point of disconnecting life support. That hospital is now part of a bigger healthcare system with a PBM program.
Dr. Seiski from Allegheny General in greater Pittsburg area has had similar results - patients surviving with counts under 2 gm/dl when presented to him. Dr. Seiski is a woman's cancer surgeon. -July 25/11 interview available as mp3 on their website.
Jan 2010 ( air date in Feb. 2010 ) in a news discussion CaucusNJ show 'The Blood Option' ( can see video in 2 or 4 parts on Youtube - pnutts27 channel ) all 3 doctors Dr. Shander, Dr. L.T. Goodnough and Dr. Friedman all agreed that doctors and the public are not taught how to administer blood - Dr. Friedman even stating about 'the appropriateness of transfusing or not' and everybody needs to be educated about the dangers of blood transfusions.'
Dr. Goodnough- chief of transfusion medicine at Stanford U Hospital mentioned that in "Massive blood loss-blood may have indeed saved your life ( 1st 24 hours ) but the price you pay is complications ( after 24 hours - if you live longer )
It is interesting that he mentioned the 1st 24 hours- if you die in that time frame they do not know if it is from the trauma or the blood transfusion. After 24 hours - dying is more apt to be from the blood.
Massive Transfusion Protocol has not shown benefit in civilian trauma patients - there is a 113 page document ( module one ) from US gov't on this
Thus PBM should be applied to trauma survivors who have massive bleeding -
Most things in the programs are available in most even small hospitals- after all - how did they cope in Haiti after the eartquake- they had no 'safe' blood or otherwise to transfuse. Haiti has very high rate of infection with HIV. They used simple blood conservation methods