Pediatric emergency medicine trisk 2256 2256
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given to the patient for whom it was intended. Laboratory testing to evaluate for
hemolysis, coagulopathy, and renal function should be sent to exclude the possibility of
a hemolytic reaction (see Table 93.14 ). Additionally, an aliquot of the unit should be
returned to the blood bank for confirmation of the original compatibility testing and
labeling. For patients with severe acute hemolysis, aggressive fluid resuscitation,
sometimes including diuretic therapy is needed to maintain urine output and minimize
the toxic effects of free hemoglobin on the renal tubules.
Suggested Readings and Key References
Anemia
Bansal D, Oberoi S, Marwaha RK, et al. Approach to a child with bleeding in the
emergency room. Indian J Pediatr 2013;80:411–420.
Drucker NA, Wang SK, Newton C. Pediatric trauma-related coagulopathy: balanced
resuscitation, goal-directed therapy and viscoelastic assays. Semin Pediatr Surg 2019;
28:61–66.
Hayward CP, Moffat KA. Laboratory testing for bleeding disorders: strategic uses of
high and low-yield tests. Int J Lab Hematol 2013;35:322–333.
Jackson J, Carpenter S, Anderst J. Challenges in the evaluation for possible abuse:
presentations of congenital bleeding disorders in childhood. Child Abuse Negl
2012;36:127–134.
Blood Loss
Janz TG, Johnson RL, Rubenstein SD. Anemia in the emergency department: evaluation
and treatment. Emerg Med Pract 2013;15:1–15; quiz 15–16.
Tobian AA, Heddle NM, Wiegmann TL, et al. Red blood cell transfusion: 2016 clinical
practice guidelines from AABB. Transfusion 2016;56(10):2627–2630.
Tyrrell CT, Bateman ST. Critically ill children: to transfuse or not to transfuse packed
red blood cells, that is the question. Pediatr Crit Care Med 2012;13:204–209.
Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper
gastrointestinal bleeding. N Engl J Med 2013;368:11–21.
Hemolytic Anemia
Dhaliwal G, Cornett PA, Tierney LM Jr. Hemolytic anemia. Am Fam Physician
2004;69:2599–2606.
Ladogana S, Maruzzi M, Samperi P, et al; AIHA Committee of the Italian Association
of Paediatric Onco-haematology (AIEOP). Diagnosis and management of newly
diagnosed childhood autoimmune haemolytic anaemia. Recommendations from the
Red Cell Study Group of the Paediatric Haemato-Oncology Italian Association. Blood
Transfus 2017;15(3):259–267.
Petz LD. A physician’s guide to transfusion in autoimmune haemolytic anaemia. Br J
Haematol 2004;124:712–716.
