A glimpse at the current practice of blood transfusion in the pediatric emergency room, Medical City, Baghdad

BACKGROUND: The onus of red blood cell transfusions in the pediatric emergency rooms (ERs) is paramount, with no specified guidelines, and almost all current policies are based on the obtainable adult facts. OBJECTIVES: The aims were to study the current practice and indications of blood transfusion in pediatric ER. PATIENTS AND METHODS: This is a cross-sectional study that included 50 pediatric patients who were admitted to the ER of Children Welfare Teaching Hospital, Medical City, Baghdad, from February to May 2017. The patients were admitted to the ER for different complaints and during their admission, they received a blood transfusion. The decision of blood transfusion was made by the most senior physician at different times. Patient data were tabulated and processed using Statistical Package for the Social Sciences (SPSS) for Windows. RESULTS: The age ranged from 15 days to 13 years, with a mean of 4.9 years. The main complaint was pallor in 26%, followed by bleeding (14%). Hemolysis due to presumptive glucose-6-phosphate dehydrogenase was the major diagnosis in 16 (32%) patients. The hemoglobin ranged from 2 to 11 g/dl, and the mean was 5.6 g/dl. The majority of decisions (28 cases, 56.0%) were made by the third-year resident, who is the second call on duties. Seven patients were below 4 months of age (14%), one of them received transfusion without logical indication. Forty-three (86%) patients were older than 4 months of age, of whom 13 (26%) patients received transfusion without logical scientific bases. The stay in ER ranged from 5 h to 5 days, and the mean was 26.5 h. The duration of transfusion was ranging from 60 min to about 6 h, with a mean of 3 h. CONCLUSIONS: The study showed major pitfalls in the management of patients with anemia. The main obstacles to implementation are the lack of trained staff.