When there is a severe blood shortage it may be impossible to meet the needs of a patient who is massively bleeding. Doughty et al list a simple rule for determining to stop delivery of scarce blood to such a patient. The authors are from Barts Health London, University of London, Sunnybrook Health Sciences Centre (Toronto), University of Toronto and Oxford University.
Patient scenario: massively bleeding patient
Rule to triage a massively bleeding patient to receive palliative care:
(1) SOFA score > 11
(2) continued need for large amounts of blood components
(3) no foreseeable ability to control blood loss
Caveats to document the seriousness of the situation:
(1) there is objective evidence of a severe blood shortage
(2) there have been unsuccessful attempts to bring in blood from other sources
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