Blood Management

Blood management (also called “patient blood management”) has been defined as “an evidence-based, multidisciplinary process that is designed to promote the optimal use of blood products throughout the hospital.” That definition works well, as transfusion decisions have been made far too often in the past based on feelings, thin evidence, and whims!

Blood management programs emphasize an honest look at the risks of transfusion in comparison to the benefits, and they also embrace evaluation of alternatives to transfusion. Given the current uncertainty regarding health care costs in the US, hospitals across the country are taking a fresh look at the use of blood management programs (either outsourced or developed in-house) to try to improve transfusion practices and patient outcomes (the latter being most important).

A true blood management program is NOT simply a “should this patient be transfused?” evaluation. The best programs seek to manage patients who might need transfusion from well before they undergo a procedure all the way through their discharge. Steps include: Evaluation for and management of preoperative anemia, management of any coagulation issues that could make a patient bleed during a procedure, introperative and postoperative blood conservation, and careful evaluation of all transfusion decisions against evidence-based guidelines. For more, please check the “Learning Resources” section at the Society for the Advancement of Blood Management (SABM) site.

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