Pediatric emergency medicine trisk 2702 2702

Platelets
• Platelet count <100,000/mm3 and
active bleeding or major surgery or
trauma
• Platelet count <50,000/mm3 and
minor surgery (e.g., lumbar puncture)
or trauma or moderate mucosal
bleeding (e.g., epistaxis)
• Platelet count <20,000/mm3 and mild
mucosal bleeding
• Platelet count <10,000/mm3 to
prevent spontaneous intracranial
hemorrhage

Red cells
• Hemoglobin <7 mg/dL
• To support circulation in a setting of
acute blood loss or sepsis
• Elective transfusion of symptomatic
patient to avoid admission (only if per
institutional policy and feasible to
transfuse in ED)

Product
specifications

Platelets

Red cells

Type and cross

needed

Yes a

Yes

ABO matched

If product available Yes

Rh matched

Preferred

Yes

Irradiated

Yes

Yes

Leukoreduced

Yes

Yes

Comment

Slightly better
response to ABOmatched platelets
If Rh+ platelets to
Rh donor, anti-D
product within 72
hrs
Prevent WBCs in
product from
proliferating and
causing graftversus-host
disease
Prevent CMV
transmission in
donor white cells
b

HLA matched

Possible

No

May be useful in
setting of patient
refractory to