Critical Hgb value changed

[ukjenn231]

I'm doing a travel assignment and the hospital just implemented a new policy that the critical Hgb value has changed to 7 they must fill out additional paperwork choosing from a list of approved indications. Just curious if anyone else has seen this and also what the rationale may be for not transfusing above 7. I haven't seen any inservicing for nurses on the policy in this facility.

[ChristineN, BSN, RN]

For our ortho and gen surg pts there is normally a protocal to transfuse during the first couple days post-op if the Hematocrit drops to less than 25.

[turnforthenurse, MSN, NP]

I think it depends, but I usually see physicians transfusing once Hgb is

[Ahhphoey]

I haven't yet seen this and our docs often transfuse for less than 8.5. At one hospital I was at a few years ago, they had just begun transfusing all post op orthopedic patients who fell below 10 (with or without signs of active bleeding). I believe it was part of a study, but never learned the outcome.

[That Guy, BSN, RN, EMT-B]

[DeeAngel]

I've been told we have gone to 7 or lower for transfusions, but have not seen it actually in writing yet. The explanation given to me was that going by this criteria results in fewer complication rates overall.

I guess the logic is that the fewer transfusions you do the fewer opportunities there are for reactions.