Why has ordering transfusions become the default position?
Partly, its because transfusions are so easy. But blood is an organ, and when we transfuse patients, were actually performing a small transplant. There is no other tissue that you can transplant by just writing an order. Ordering a transfusion is much easier than, say, trying to figure out the cause and treating a patients anemia. Transfusion ends up having very little to do with a patient, but a lot to do with the ease of administration. What are the current guidelines? They havent really changed since 1988 and the first NIH consensus conference. Over the years, guidelines have become more restrictive in terms of using all blood products, which is an improvement. Hopefully, guidelines will be updated to reflect evidence that has come to light since they were first produced. Your study looked at 450 different clinical scenarios among patients without active hemorrhage or trauma and found transfusion benefit in only 12%. Who are the patients who benefit? Those were mostly patients with
