7.5 Clinical conditions that require a clinical transfusion guideline

Examples are given of procedures where possible and thses are currently used in hospitals in countries participating in the project.

Table 7.2 Clinical situations for which there should be transfusion guidelines

Major Haemorrhage Procedure
Situation Use this space to note reference to local clinical transfusion guideline or relevant example

Blood ordering and supply in major haemorrhage

The management of major haemorrhage in

  • Gastrointestinal (variceal non-variceal) acute upper GI bleeds

  • Obstetrics

  • Trauma

Critical Illness (transfusion in the intensive therapy unit)

Preoperative assessment and optimisation

Predeposit autologus blood – collection and transfusion

Management of preoperative patients on drugs that affect haemostasis, such as


warfarin, heparin, clopidogrel


Peri-operative blood management and blood saving techniques/drugs

Inherited coagulation disorders

Acquired coagulation disorders

Disseminated intravascular coagulation

Thrombocytopenia and thrombocytopathy, TTP

Prenatal and neonatal transfusion

Haemolytic disease of the newborn: prevention and management

Neonatal: exchange, intrauterine and top-up transfusion

Chronic anaemia due to haematological disorders



Autoimmune haemolytic anaemia

Malignant haematological disorders: bone marrow failure

Transplantation of haemopoietic stem cells

Management of patients refusing blood transfusion