New Transfusion Guidelines

New transfusion guidelines were adopted by MEC in August 2013.

This letter is to provide education on changes to practice guidelines related to the safe use of blood and blood products at Aiken Regional Medical Centers. Patients excluded from these practice guidelines include those actively bleeding, trauma, pediatrics, oncology and/or those requiring massive transfusion.

The criteria for use include:

  • Hematocrit ≤21 percent or Hb ≤7.0 in stable (no symptoms) patients without bleeding, cardiovascular or end stage renal disease
  • Hematocrit ≤24 percent or Hb ≤8.0 in coronary artery disease (CAD), unstable angina, myocardial infarction (MI)/cardiogenic shock and hemodialysis with end stage renal disease (ESRD)

And the process for administration includes:

  • A single unit of red cells will be released at a time
  • An H&H must be ordered after the single unit transfusion
  • The patient must be clinically reassessed and documentation provided for a second RBC unit

These changes in practice are to assist in reducing variability in transfusion practices, better utilization of blood and blood products and to reduce the risks of complications from blood transfusions. Cerner has a new program that will be implemented in early June, to help guide you with transfusion decisions.

When a blood product is ordered, if the transfusion falls out of the new guidelines, a new field will pop up where the reason for transfusion will have to be filled in from a drop down box of choices (see attached).

Other is a choice and the reason can be free text.

All outlines will be reviewed and the physician contacted by the Transfusion Committee.

Thank you for your anticipated cooperation.

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