Choosing Wisely: Five Anemia, Transfusion Practices to Avoid

By the Editors

The Society for the Advancement of Blood Management has released a list of five practices clinicians should question as part of the Choosing Wisely campaign. Here are the recommendations:

• Delay elective surgery in patients who have correctable anemia until the anemia has been treated.

• To avoid iatrogenic anemia, don't order blood tests unless they are clinically indicated.

• Avoid plasma transfusion if there is neither active bleeding nor laboratory evidence of coagulopathy.

• To manage surgical bleeding, use antifibrinolytic drugs (e.g., tranexamic acid) rather than blood transfusion when possible.

• In nonemergent settings, avoid transfusion when other treatments are available. Discuss alternative strategies during the informed consent process.