Blood transfusions may be required in patients with severe anaemia or symptomatic anaemia. If the cause of the anaemia is not medical (eg menorrhagia), please discuss with the appropriate specialty before considering/ arranging an acute admission under the medical team.
See these Remedy links for information about transfusions, and how to refer for blood/ iron transfusions, including
- When to consider referral for iron transfusion, and contraindications
- Referral to NBT, including the information required in the email and the referral proforma/ pathway
- Referral to UHBW (BRI)
- Referral to Weston - Medical Day Unit may have capacity for next day. Phone to check. To refer to Medical Day Case unit, they like GPs to phone them on 01934 636363 (ask for medical day case). The Unit is open 09:00-18:00 Monday to Friday. Referrals can also be emailed to wnt-tr.gp-mdcu@nhs.net. If there is no capacity on Medical Day Unit, transfusions can also be done on AEC.
- Community blood transfusions (North Somerset patients only, at Clevedon Hospital)
Requests for blood transfusion should be considered in patients with
- Hb < 70g/l, or
- Hb < 80g/l with history of cardiovascular disease or with symptomsg. chest pain, breathlessness, hypotension, tachycardia, cardiac failure.
Requests for transfusions should be made directly to the appropriate medical day unit except in the following patients
- Oncology patients requiring transfusion should be discussed with the appropriate oncology team or via the on-call oncologist
- Renal patients requiring transfusion should be discussed with the renal team at Southmead hospital.
NB Southmead SDEC is willing to accept referrals for transfusions if this cannot be facilitated by MDU and the patient otherwise meets SDEC criteria.
Determining the need for admission or outpatient management (eg. medical day unit) will depend on a number of factors
- Level of anaemia
- Symptoms of anaemia (significant SOB, chest pain, etc would favour admission)
- Observations (haemodynamic instability would favour admission)
- Evidence of significant recent blood loss (melena should be admitted, high urea can suggest recent blood loss)
- Anticoagulation
- Evidence of a rapid drop in Hb (eg. normal Hb 1 week ago and now Hb60 would favour admission)