Pediatric emergency medicine trisk 2670 2670

Anemia

Hemoglobin < 7 g/100 mL

Please see Table 98.7 for
special guidelines for
transfusions in the
oncology population

Symptoms related to low red If severe anemia, transfuse
blood cell mass
slowly to avoid
precipitating congestive
heart failure
Thrombocytopenia

Coagulopathy

CNS symptoms

Platelet count < 150,000/mL

Please see Table 98.7 for
special guidelines for
transfusions in the
oncology population
PT, PTT, fibrinogen, d-dimer Fresh frozen plasma 10
mL/kg
If hypofibrinogenemia exists
in isolation, treat with
cryoprecipitate, 1–2 U/10

kg
Platelet transfusion if count
<50,000/mL
Leukopheresis and lumbar
puncture may be
contraindicated until
coagulopathy corrected
Neurologic examination
Leukopheresis to decrease
viscosity and leukostasis,
if WBC >100,000/mL and
symptomatic
WBC count to screen for
Correct coagulopathy (see
hyperleukocytosis
above)
PT, PTT, fibrinogen, d-dimer Platelet transfusion if count
to assess risk for CNS
<50,000/mL
hemorrhage
Serum electrolytes
Initiation of chemotherapy is
best management for CNS
leukemia or chloroma
Head and/or spinal cord
Consultation with radiation