What does everyone use for a Hgb and Hct criteria for transfusion?

When dealing with the hospitals regarding if a "reference call in" (we are a blood center) is an emergency at 2 AM, I've found that most of the hosp. in this area let each Dr. push them into tx. when they (Dr.) feel like it. I've seen pt. tx. 2 units at 9.9 and 30 because the rest home will not keep them there with a low crit. Hard numbers are hard to stick with because each situation is so different. I worked with an elderly tech. during her chemotharapy that would work with a crit. of 18-20. Chronic anemia vs acute anemia? In a level one trauma center there are almost too many situations to have a "set tx. point" After all that blather,,,, we push for 7 and 21 in non-emergency/surgery situations. Again let me state that I personally do not think there is an all inclusive set point that will fit all of your transfusion needs.

At the end of each month, I do an audit of all units given. Our H/H policy is 8.5 and 27.0. Anything that does not meet that criteria is passed on to our Performance Improvement department. They have someone who then reviews the chart to try to "justify" the transfusion. If she can't find documentation to justify it, it then gets sent back to the Dr. for his justification comments.

Our triggers are hgb of 8 and HCT of 24.

Our trigger has been hgb of 8 and HCT of 24, however, we are trying to educate our physicians that is just one part of the evaluation. Many people can tolerate much lower hgb. Age, overall health, perfusion all play a role. Indeed, we are looking to lower this to hgb of 7., but this should not be the only guide. yvette bunch