Background: Patients with COVID-19 have increased rates of venous thromboembolism, however, there is currently no standardized approach to anticoagulation (AC) therapy particularly with respect to the proper dose of anticoagulation (prophylactic or therapeutic). Many observational studies have shown a mortality benefit in using prophylactic AC for hospitalized patients with COVID-19. A few studies have reported [...]

Background: Sickle cell disease (SCD) affects about 100,000 people in the US. The disease causes significant mortality, morbidity and frequent hospitalizations secondary to primary manifestations of the disease and its complications. We conducted a retrospective, single institution study in adult patients (pts), ≥ 18 years with SCD to assess factors associated with health care utilization [...]

Background: Many red blood cell transfusions (RBCT) are unnecessary or harmful according to clinical trials and guidelines. These RBCT put patients at risk and waste scarce healthcare resources. Clinical decision support (CDS) using the Epic™ computer provider order entry system has reduced unnecessary transfusion (Goodnough et al, Transfusion 2014) at one center with a post-intervention [...]

Background: Patients undergoing cardiac surgery are at risk of anemia from blood loss, inflammation, and red blood cell lysis, necessitating blood product utilization and increasing the risk of post-operative complications. RBT-1 (a combination of stannic protoporfin and iron sucrose) is a novel preconditioning drug administered prior to surgery that upregulates anti-inflammatory, antioxidant, and iron scavenging [...]

Background: In the past 20 years, the “10/30” rule for blood transfusions has been replaced with conservative guidelines which have demonstrated improved patient outcomes and reduced overall healthcare costs. Hospitals across the country have enlisted transfusion subcommittees to review the appropriateness of blood transfusions. Within medical training, resident physicians rotate with different attendings who have [...]

Background: Hemorrhagic complications after cardiac catheterization (CC) and percutaneous coronary intervention (PCI) are associated with an increased risk of mortality. In review of a large catheterization registry, blood transfusions were required following 1.4% of radial access and 2.8% of femoral access PCIs, respectively. While there is a standardized protocol for obtaining a blood type and [...]

Case Presentation: A 52-year-old woman presented to the emergency department with altered mental status, headaches, and bilateral visual loss. She was admitted a month prior due to severe anemia with hemoglobin of 1.6 grams per deciliter resulting from chronic menorrhagia. She had received multiple blood transfusions at that time.On presentation, her blood pressure was 130/62 [...]

Case Presentation: 48 y/o African American with h/o obesity and HTN on Enalapril, menorrhagia was sent in by PCP for low H/H of 6.3/23. Patient has been having chronically heavy menses associated with large clots. Her usual hemoglobin is around 9-10mg/dL. Denies any other symptoms.Patient was admitted to medicine for anemia requiring blood transfusion. Cross [...]

Background: Routine transfusion of platelets and Fresh Frozen Plasma (FFP) prior to paracentesis is among the “things we do for no reason”, as recommended against by the American Association of Liver Disease and American Gastroenterology Association in patients with platelets over 20,000. We hypothesize that a Medicine Procedure Service (MPS), which has adopted this recommendation [...]