An actively bleeding patient was denied transfusion by a conservative practitioner who adheres to a strict 7-g/dL hemoglobin threshold, prompting this column from cardiologist Melissa Walton-Shirley.
But we liberal transfusionists are challenged on every request for consideration of transfusion. Whereas the polite may resort to whispered skepticism, vehement critics respond with scorn as if we'd asked them to burn aromatic herbs or fetch a bucket of leeches. And to what do we owe this pathological angst? The broad and persistent misinterpretation of the.
Additionally, anemic people who are hemodynamically stable but can't walk without new significant shortness of air or new rest angina need blood, and sometimes at hemoglobin levels higher than generally accepted by conservative strategists. Finally, failing to treat or at least monitor patients who are spontaneously bleeding as aggressively as some trauma patients is a failure to provide proper medical care.
But those proud transfusion conservatives who will not budge until their threshold is met need to make certain their patient is truly subject to their supposed edicts. Our blood banks should not be more difficult to access than Fort Knox, and transfusion should be used appropriately and liberally in the hemodynamically unstable, the symptomatic, and active brisk bleeders.
Patient Safety Disaster Disaster Medicine Toxicology Toxicity Poisoning Toxins Angina Angina Pectoris Hemoglobin Hb Hemoglobin Hgb Hb - Hemoglobin Acute Coronary Syndrome ACS - Acute Coronary Syndrome Acute Coronary Syndrome (ACS) Transfusion Hemorrhage Bleeding Myocardial Infarction Blood Fellowship Fellows Residency Residents Syncope Fainting Sinus Tachycardia
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