[HSF] blood product in open heart surgery

Sat Mar 31 11:45:11 EDT 2007

Dear Miranda,
Thank you for clarification. It releaved me to know that at least  inBrazil 
there are some centers with the facilities close to us..Any way at least in 
the next 10 years I will be working as my own bare foot hematologist( 
reference to chinese medical system during the great famine days).
erdinc
PS:hematologists are not very interesred in this type of job.( at least 
those whom I know)

>From: "claudia miranda" <cvteles at gmail.com>
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] blood product in open heart surgery
>Date: Mon, 26 Mar 2007 17:11:23 -0300
>
>Prasanna,
>
>You are so kind, as always.
>I would like very much  to see you operating. It must be showtime! :-)
>In Brazil it is common for a physician to have many jobs. I spend my
>wednesday nights inside a local small hospital ICU, where I keep my hands
>skilled with the procedural part of my intensive care nature  - and every
>other week I spend 12 hours during the weekend  in a prehospital setting
>emergency system gathering the pieces of some trauma victims - this is only
>to keep my epinephrine circulating. :-)
>I still work in that government hospital, but not in the post surgical ICU
>- recently I was invited to be the responsible for the anticoagulation and
>hemostasis clinic there, and also to work as a clinical research physician.
>I do this during the morning. In my private practice,  I take care of the
>hemostasis lab of one of the best hospitals in my town,  during the
>afternoon.Right now, I am writing to you from this private hospital´s ICU  
>-
>which is right beside the lab, and where I spend a lot of time, attending
>rounds, discussing lab results, etc.
>Now, of course I was pulling his leg.
>We did not have an hematologist at our hospital until recently.
>Ten years ago, the blood bank coordinator in the poor government hospital
>where I developed my practice was a paediatrician. The blood bank was a
>small cubicle with a fridge, and a microscope. She decided to take care of
>that because no hematologist was available in the state government health
>care department that would voluntarily apply for the job.
>This nice and caring doctor - who became by practice a true commited
>hemotherapist and hematologist,  has enrolled a specialization course and
>was kept on charge during all these years - but she´s  had a lot of hard
>work, many times performing selfteaching and lonely research to discover 
>how
>to deal with some problems. She now counts with two hematologists and
>several technicians with her, both of the docs did medical residence
>training in hematology/hemotherapy like me, but since I am the
>only hematologist in the hospital who also has critical care and
>cardiovascular background, and who is deeply interested in coagulation and
>hemostasis,  I pilot the rotational  thromboelastometer at the OR together
>with the anaesthesiology team, and also  take care of the anticoagulation
>clinic - which is fastly becoming an independent department at our 
>hospital.
>We only achieved this number of professionals after many years of constant
>complaints to our health system administrators who, most of times simply
>ignore the need for a specialized professional for running the blood bank.
>
>Erdinc, I believe you have a hospital, and I understand your point of view,
>of course, but your institution will improve a lot in quality if you demand
>from the ones who set the rules that they bring you an hemotherapist and
>hematologist who really enjoys the job. Find an hematologist who enjoys
>molecules, cells and coag cascades to help you. Molecules are important for
>surgeons and anaesthesiologists.
>
>My 0,00000000000000000000002 brazilian cents.
>
>Claudia Teles, MD
>Hematologist and Intensivist
>Hemostasis Lab Medical Coordinator  - Pro Cardiaco Hospital
>Anticoagulation Clinic - Instituto Estadual de Cardiologia Aloysio de
>Castro.
>
>
>
>
>
>
>2007/3/23, prasannasimha <prasannasimha at gmail.com>:
>>
>>Erdinc,
>>She is pulling your leg . She has also worked in a government hospital
>>before going to a plush job in private practice. She has gone through
>>the same trials and tribulations as us . She has struggled to become a
>>top notch hematologist now and I always wait for her opinions on
>>hematological problems.
>>Prasanna
>>erdinç naseri wrote:
>> > Claudia,
>> > Although I completely agree with you that a medical school hospital
>> > must have a well developed blood bank and at least a hematologist, I
>> > am sure that not all the hospitals in the world have a hematologist(
>> > even USA) and still they are considered as hospitals .
>> > Erdinc Naseri
>> > Tokat medical school-Turkey
>> >
>> >> From: "claudia miranda" <cvteles at gmail.com>
>> >> Reply-To: OpenHeart-L at lists.hsforum.com
>> >> To: OpenHeart-L at lists.hsforum.com
>> >> Subject: Re: [HSF] blood product in open heart surgery
>> >> Date: Fri, 23 Mar 2007 14:04:33 -0300
>> >>
>> >> WHAAAT?
>> >> No hematologist in the hospital??????
>> >> Then you don´t have an hospital at all.
>> >> :o)
>> >>
>> >> Claudia Teles, MD
>> >> Hematologist- Intensivist
>> >> Lamina Laboratories - Pro Cardiaco Unit
>> >> Anticoagulation and Hemostasis Clinic
>> >> Instituto Estadual de Cardiologia Aloysio de Castro
>> >> Rio de Janeiro, Brazil.
>> >>
>> >>
>> >>
>> >>> No hematologist in the hospital
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