Guidelines for red blood cell and plasma transfusion for adults and children: an emergency physician's overview of the 1997 canadian blood transfusion guidelines part 2: Plasma transfusion and infectious risk

Abstract

The Guidelines project addresses one of the most difficult issues in clinical medicine: the issue of how and when to administer blood. The project was funded by the Canadian Blood Agency, the Canadian Red Cross Society, and Health Canada. The Board of the Canadian Medical Association appointed eight highly qualified candidates to the expert working group (EWG). An advisory panel, representing 26 health and medical organizations, was also formed and provided input to the EWG. The EWG reviewed ethical and legal issues surrounding blood transfusion, conducted focus groups across the country to determine the needs of clinicians, and critically appraised the relevant clinical literature from 1966 to 1996. The product-Guidelines .for Red Blood Cell and Plasma Transfusion--were then subject to peer review and published in the Canadian Medical Association Journal (1). They have been endorsed by the Canadian Association of Emergency Physicians (CAEP) and 23 other health care and medical specialty organizations. The Guidelines were developed specifically to help clinicians make appropriate decisions about red blood cell and plasma transfusion. Like all guidelines, they should be interpreted and modified according to local needs and constraints, and are not intended to define care rigidly. The Guidelines deal with several issues of importance to Canadian emergency physicians. Part 1 of this article, in the last issue of JEM. dealt with red blood cell transfusion. Part 2, in this issue, will focus on plasma transfusion and transfusion risks. Readers wanting fllrther details on the process of guideline development and the rationale for the transfusion guidelines are referred to the complete document (1).