<p>In all cases you will resuscitate with crystalloid, non-human derived colloid (e.g., hetastarch) before considering allogenic blood. Some JW will allow cell saver blood.</p>
<p>The bind of course comes when you believe a blood transfusion is necessary to save a life. Transfusions of minor children of JW parents have been considered carefully by the courts.</p>
<p>You may not, of course, give a transfusion without consent. The usual procedure is to obtain a judicial order to give the transfusion as a life saving measure against the wishes of the parents. This sounds awkward and time consuming, but every judge is familiar with the procedure and able to give the order at any time of day or night.</p>
<p>For an eight year old, the case law is clear: document the indication, get the order, give the transfusion, save a life. For older minors who might be able to give or refuse to give informed consent, the scenario is trickier.</p>
<p>There are entire sites devoted to JW and transfusion: <a href=“http://www.noblood.org/[/url]”>http://www.noblood.org/</a></p>
<p>Here is a case from Massachusetts Superior court: <a href=“http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=ma&vol=appslip/99p0199&invol=1[/url]”>http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=ma&vol=appslip/99p0199&invol=1</a></p>