question and answer
A case for emergency blood transfusion
October 2004
A query from JEFF UNGER, MD, of Victoria, BC: "In non-trauma patients, is there any evidence-based clinical indication for emergency blood transfusion?"
In a patient with acute blood loss and hypotension, whether due to trauma or other causes -- e.g. massive GI bleeding, ruptured aortic aneurysm -- transfusion of emergency blood may be justified. I'm not aware, however, of any evidence-based data for other types of anemias. In cases other than acute blood loss, it's very unlikely that you have no time to wait for availability of cross-matched blood. But in a patient with severe anemia who has severe coronary insufficiency or has to be airlifted to a health centre, if in your judgement you believe that waiting for cross-matched blood will put the individual's life in danger, you could use emergency blood and no one would criticize you. MS

Reference:
Corey et al. NEJM 2004;350(1):11-20.
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