Blood Donation

There are fears that in the year of 2012 the United Kingdom will have a blood shortage, which may cause issues at the Olympic Games and other events, with "extra bank holidays leading to a drop in donations as most people give blood during the working week" (http://www.bbc.co.uk/news/health-16338795).

Blood, after being taken from donors, is collected in plastic bags which "contain anticoagulents and other preservatives" (http://tinyurl.com/d7zfw2h). Anticoagulents are drugs used to thin out blood and stop it clotting (coagulating), therefore making it useable for transfusions. The bags that the blood is stored in have a "material that allows for diffusion of gasses permitting optimum cell preservation" (http://tinyurl.com/d7zfw2h).

Once it has been bagged and taken to where it is to be stored, it is then "tested for Hepatitis B and C, HIV as well as other infectious diseases" (http://tinyurl.com/d7zfw2h) to make sure it is fit for use. It is then "stored in a fridge for up to 42 days, or frozen for up to 10 years" (http://tinyurl.com/d7zfw2h).

This means that a huge volume of blood can be stocked. On the National Blood Service website (http://www.blood.co.uk/StockGraph/stocklevelstandard.aspx) there are a number of graphs to show the stocks that are donated daily and also the stocks in the whole country (except for blood held in hospitals).

So on the BBC News website there is a quote from NHS Blood and Transplant that we will need "2 million pints (1.1 million litres) of blood plus an extra supply for Olympic visitors" (http://www.bbc.co.uk/news/health-16338795).

HRH Prince Phillip left Papworth Hospital yesterday morning and is home with his family.

Cardiothoracic Surgery

With news yesterday that an 18 year old was stabbed in the heart yesterday on Oxford Street, I thought it would be a good time to talk about surgery that can be carried out to save someone who has been stabbed in the heart.

The process needs to be carried out extremely quickly due to the loss of blood from the heart whilst it continues to contract, which means that the victim needs to be transported to the nearest cardiothoracic theatre as soon as possible for a good chance of survival. The problem is that not all hospitals do cardiothoracic sugery (surgery on the heart), there are a number in London, as well as private hospitals all over the United Kingdom but not all cities have specialist cardiothoracic surgeons at their local hospitals.

To start the heart surgery the surgeon will open the chest cavity "through the patients breastbone" (http://tinyurl.com/czudd7b) with an incision and then pull the rib cage open using a surgical tool called a 'haight-finochietto rib retractor', which then opens up the area of the chest that the heart sits in. It should take the surgeon one minute from making the incision in the breastbone, to having has his hands on the heart.

At this point the surgeon can make a decision whether to use a "heart-lung bypass machine, which takes over the hearts pumping action and moves blood away from the heart and allows the surgeon to operate on a heart that isn't beating and has no blood in it." (http://tinyurl.com/czudd7b). Or he can do surgery on the heart while it is beating, where they will use a clamp to steady one section of the heart that needs surgery, whilst the rest of the heart beats regularly. This second process takes a lot of skill and a very steady hand.

In the case of a stabbing there will be a hole in the heart which needs to be stitched up to stop the bleeding. To get to the heart the 'pericardium' needs to be penetrated. This is a "fluid filled sack that surrounds the heart; and works to keep the heart contained in the chest cavity, limit heart motion and prevent the overexpansion of the heart" (http://tinyurl.com/dxe7deb). Once the pericardium is penetrated, the surgeon is free to stitch up the stab wound and stop the bleeding.

After the surgeon has stitched up the wound and taken off the clamp/released the heart-lung bypass machine, he can either stitch up the pericardium or leave it unstitched. If he were to stitch it up this could "increase the risk of a cardiac tamponade, a compression of the heart that can occur when blood/fluid builds up between the myocardium (heart muscle) and the pericardium" (http://tinyurl.com/crysoby).

This shows that not only does a surgeon have to be very quick in his decision making, he also has to be very calm, as he only has one chance to get it right. To see this process in action click on the link (http://www.youtube.com/watch?v=hM4u2PXyBpg), but please note that it contains images of open chest cavities and live surgery.

Unfortunatly the 18 year old who was stabbed died on scene with a single stab wound and was unable to receive any medical attention.

HRH Prince Phillip

The news came out today that HRH Prince Phillip, The Duke of Edinburgh, has had a stent put into his coronary artery (the artery that takes blood to the heart muscle) due to a blockage and had caused him chest pains, known as angina.

He was flown to Papworth Hospital which is a specialist cardiothoracic hospital. This means that it deals with "diagnosis and management of surgery in conditions of the heart, lungs and oesophagus" (http://www.nhscareers.nhs.uk).

Now, a stent is a "small mesh tube used to treat narrow or weak arteries" (http://tinyurl.com/c26r4wl).

So what this stent effectively does is keeps the arteries open so that blood flow to the heart is restored, this is known as “angioplasty" (http://tinyurl.com/c26r4wl).

The way that this stent is inserted is by making a small opening in a blood vessel “in the upper thigh, arm or neck and then feeding a tube, with the stent lying on a deflated balloon, into the opening in the blood vessel. The doctor will then observe his movements of the stent by X-ray " (http://tinyurl.com/c26r4wl) so that he can position the stent in the right place of the coronary artery. He will then inflate the balloon in the right area, where the blockage is and the stent will be in place to keep the artery open. "Over time the cells in the artery wall will grow over the stent and it will be permanently fixed in the artery" (http://tinyurl.com/c26r4wl).

The Royal biographer; Penny Junor said, "He is an extraordinarily fit man. He takes a lot of exercise and he does an awful lot of work." (http://www.bbc.co.uk/news/uk-16325517). It is rather unusual for this to happen to someone who is so active, but it could be the result of a blood clot or a plaque that has formed, which is to do with the high blood pressure in the arteries. Because of the fact he is 90 could owe to the fact that his arteries are weaker, as the muscle and elasticity has become harder and not so strong.

Getting Started

So starting out in the blogging world... I've set this up to not only introduce medical knowledge and science in news to you, but also to try and find out about it myself. I am looking to do medicine at University and there is no better way to prepare for it than to start writing and really having a passion for it.

I hope you enjoy this blog and will join me on the journey. I only have One Life, and therefore One Chance at making a difference to peoples lives through medicine.

Benjamin