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How do you treat severe anemia in individuals who cannot receive blood products?

Answer: It depends on the clinical presentation.

  • For all: improve iron, B12, and folic acid stores; limit phlebotomies; and consider early use of an ESA.
  • Acute and chronic bleeding: focus on source control.
  • Operative management:
  • Screen and treat anemia.
  • Discuss in detail which blood products would be considered acceptable, and document this in the chart.
  • Discuss strategies to lower blood loss with anesthesia and surgery (Cell Saver, etc.).
  • Use pediatric tubes for phlebotomy.
  • Add an EMR alert.

Source: Treatment of individuals who cannot receive blood products for religious or other reasons