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CHAPTER 93 ■ HEMATOLOGIC EMERGENCIES
STACY E. CROTEAU, ERIC W. FLEEGLER, MARISA B. BRETT-FLEEGLER

GOALS OF EMERGENCY THERAPY
The management of pediatric hematologic emergencies is directed toward immediate
stabilization of the acutely ill patient to prevent morbidity and mortality related to severe
anemia, infection, bleeding, and thrombosis. Profound anemia requires simultaneous
hemodynamic stabilization and elucidation of the underlying etiology. Patients at risk
for infection and sepsis, such as neutropenic or asplenic patients, require prompt
attention; quality metrics focus on time to initiation of antibiotic therapy for these
patients. Significant hematologic findings of unknown etiology require thorough
evaluation, especially where necessary therapies may obscure the underlying diagnosis
or impede later diagnostic testing.
Hematologic emergencies arise in children who have been previously well, who have
known blood disorders, or who have systemic disease. Initial measures of support,
diagnosis, and treatment are based on general principles that often do not require a
definitive diagnosis to initiate management.
KEY POINTS