- Haemodynamically stable
- No evidence of ongoing haemorrhage, underlying medical disorder
- Symptoms and signs of anaemia(palpitations, fatigue, fainting spells, shortness of breath, pale skin)
- Haemoglobin value
[CG] Postpartum Blood Transfusion in Stable Patients
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To develop a policy of prescription of blood transfusion based on symptoms and signs rather than based on haemoglobin value. To minimize the number of units transfused without comprising the benefits of transfusion.
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Blood transfusion though life saving is not without hazards. The risk of complications (immunologic, non immunologic) increases with the volume of transfusion. It is important to avoid unnecessary exposure to allogenic blood products. Due to safety concerns, many recent studies on restrictive transfusion policy have been published and they have been shown to be effective.2,3,4 Moreover the number of red cell units ordered are not always utilised and can lead to significant wastage.1
70 - 89g/l
|Iron therapy||Evaluate signs & symptoms||Evaluate signs & symptoms|
|Asymptomatic - alternative therapy||Discuss with senior|
|Symptomatic – prescribe single unit||Symptomatic – transfuse as
|Re evaluate after single transfusion||Single/multiple units|
|Still symptomatic – discuss with Senior
regarding further transfusion
- Discuss the potential risks and benefits of blood transfusion with the patient and clearly document in the case notes.
- Fully complete the Blood Component Prescription and Record of Transfusion form.
- Alternative therapy – oral iron therapy, parenteral iron therapy
- Seniors - Registrar, Consultant
- Patient declining transfusion- Discuss with Seniors