Haemorrhage, Transfusion & Patient Blood Management
Recognise major bleeding and coordinate resuscitation, source control and safe transfusion.
Quick revision ↓ Medical Dictionary
01Recognise bleeding
Assess mechanism, procedure, visible loss and signs of poor perfusion. Internal bleeding may be substantial without external evidence, and an early haemoglobin result may not reflect the full acute loss. Activate the appropriate major-haemorrhage pathway when clinical circumstances require it.
02Control the source
Resuscitation must accompany definitive bleeding control through the relevant surgical, interventional or other pathway. Waiting for every laboratory result can delay essential action. Communicate clearly about blood products, team roles and evolving physiology, with repeated assessment of response.
03Transfusion safety
Check identity, compatibility requirements and the product through the prescribed process. Observe for reactions and stop the transfusion with urgent assessment when a significant reaction is suspected. Accurate documentation and communication matter during emergencies as well as routine transfusion.
04Physiological consequences
Major bleeding can be complicated by hypothermia, coagulopathy, acidosis and electrolyte disturbances. Monitor and treat through the haemorrhage protocol. Balanced care addresses the whole physiology rather than relying only on replacement of red cells or a single haemoglobin target.
05Avoid unnecessary exposure
Outside major haemorrhage, transfusion decisions depend on symptoms, haemoglobin, comorbidity and current guidance. Investigate and treat anaemia where possible, including before elective surgery. Discuss benefits and risks, and reassess after treatment rather than giving an automatic fixed number of units to everyone.
High-Yield Revision
- Early haemoglobin can underestimate the significance of acute bleeding.
- Source control and resuscitation must proceed together.
- Identity checks remain essential during urgent transfusion.
Common Pitfalls
- Waiting for a low haemoglobin before recognising shock.
- Treating all anaemia with automatic transfusion.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 29 September 2026. Consult current local protocols for prescribing, procedures and escalation.