Choosing Wisely Canada – Transfusion Recommendations

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Recommendation #1 – Don’t transfuse blood if other non-transfusion therapies or observation would be just as effective.

Recommendation #2 – One Unit Transfusion

Recommendation #3 – Plasma Transfusion

Recommendation #5 – Don’t routinely use plasma or prothrombin complex concentrates for non emergent reversal of vitamin K antagonists.

Recommendation #9 – Don’t transfuse O negative blood except to O negative patients and in emergencies for female patients of child-bearing potential of unknown blood group.

Choosing Wisely Manitoba – New Preoperative Documents To Help Reduce Unnecessary Testing

Please review the links below to familiarize yourself and your clinical area about the updated evidence informed clinical practice guidelines for practitioners ordering preoperative laboratory tests for adult patients undergoing elective surgery. To review the updated guideline and accompanying algorithm, follow the links below: 

Routine Preoperative Tests for Adult Patients Undergoing Elective Surgery Clinical Practice Guideline.

Preoperative Lab Test Guideline – Algorithm

Guidelines for Requesting Type and Screen in Adult Elective Surgical Patients

Canadian Anesthesiologists Society Recommendations

Choosing Wisely 2015

Choose Wisely Campaign Top Ten Things Patients and Physicians should question:

Don’t transfuse red blood cells for arbitrary hemoglobin or hematocrit thresholds in the absence of symptoms, active coronary disease, heart failure or stroke.

Indications for blood transfusion depend on clinical assessment and are also guided by the etiology of the anemia. No single laboratory measurement or physiologic parameter can predict the need for blood transfusion. Transfusions are associated with increased morbidity and mortality in high-risk hospitalized inpatients. Adverse events range from mild to severe, including allergic reactions, acute hemolytic reactions, anaphylaxis, transfusion related acute lung injury, transfusion associated circulatory overload, and sepsis. Studies of transfusion strategies among multiple patient populations suggest that a restrictive approach is associated with improved outcomes.

Download Transfuse Safely Poster

Additional Transfusion Medicine resources are available by clicking here to review the AABB website.