The decision to transfuse blood, blood products or plasma derived must be based on a careful assessment indicating that transfusion is necessary to save life or prevent major morbidity.
Blood transfusion should not be the first consideration during the management of patients with acute haemorrhage, as in many cases blood volume replacement is initially more urgent than red cell replacement.
Initial management to prevent further blood loss, positioning of the patient to ensure optimal flow of blood to vital organs and ensuring adequate blood pressure and oxygenation are priorities. Appropriate volume replacement with plasma substitutes (crystalloids or colloids) will obviate the need for transfusion in most cases.
In areas where malaria is endemic
, blood transfusion to a patient from a non-endemic area should prompt routine antimalarial therapy. Blood for transfusion purpose should be taken only from carefully selected donors from populations at low risk of transmitting infectious agents. This blood should then be tested for transfusion-transmissible infections before being transfused.
Only in a life-threatening situation should an exception be made to these recommendations.
||The Blood Care Foundation - A charitable organisation dedicated to the provision of screened blood and resuscitation fluids in countries where these are not readily available More information.