The ideal method of blood transfusion seems to me to require that
it shall be absolutely certain of success, that the blood shall
not necessarily be injected into the patient immediately it has
been drawn, so that other circumstances besides the demands of the
transfusion operation can be considered, and that no injury shall be
done to the donor beyond the puncturing of a vein. In addition to
this, the method should be so simple and free from special apparatus
that it can be easily learnt and carried out by one operator without
skilled assistance. All these requirements are fulfilled by the
citrate method, and a satisfactory method of performing this will
next be described. As will be seen, the blood can be drawn with the
minimum amount of injury to the donor; when drawn, it can be put
on one side, for several hours if necessary, and then given to the
patient at whatever may be judged to be the most favourable moment;
the whole process can be carried out by a single operator without
any assistance; and finally, but little practice is needed to make
success certain every time.
The transfusion apparatus known as “Robertson’s bottle,” first
described by Oswald Robertson in 1918, is the basis of most citrate
methods. This could be easily improvised in a field laboratory, and
was extensively used during the last year of the war. The apparatus
consisted of a glass bottle of about a litre capacity, the mouth
of which was closed by a rubber bung. Through the bung three glass
tubes passed. One, connected by a short rubber tube with a wide-bore
needle, ended about an inch from the bottom of the bottle; through
this the blood flowed into the bottle. A second tube, which reached
to the angle between the side and the bottom of the bottle, was
connected by a rubber tube with a cannula; through this the blood was
injected into the patient. The third tube reached only just beyond
the bung, and to this was attached a Higginson’s syringe, by means of
which either negative or positive pressure would be produced inside
the bottle, according to which end of the syringe was attached.
Public-domain text, read in full here on John Shaqi.
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