ABSTRACT
IS THE PATIENT’S LIFE AT RISK? ■ Several clinical situations involving anemic patients war-
rant immediate evaluation and treatment. ▲ Active bleeding, especially if hypovolemia or shock is
present ▲ Evidence of myocardial ischemia (e.g., angina pectoris,
myocardial infarction) and/or ischemia of other tissues ▲ Evidence of new-onset hemolysis
ADDRESSING THE RISK Active Bleeding, Especially if Hypovolemia or Shock Is Present ■ Obtain IV access with 2 large-bore (16-gauge if possible)
catheters for rapid fluid resuscitation and/or transfusion. Resistance to flow is determined by both the length and diameter of the catheter. A short peripheral IV catheter causes less resistance to flow than a long central line of the same diameter. Hence, peripheral IV catheters may be better suited for rapid fluid resuscitation and/or transfusion than a central line.
