The chapter discusses the diagnosis and critical actions for acute chest syndrome in patients. For acute chest syndrome, administration of oxygen, IV pain medications, and antibiotics are critical actions. Obtaining a CXR is key in this case, and albuterol should be given in patients with bronchospasm. Painful crises that are not typical of the patient’s usual symptoms should elicit a search for more serious complications of sickle cell disease.

This chapter charts the evolving role of the League of Red Cross Societies in blood transfusion, one of the most significant medical therapies of the twentieth century. Blood transfusion programmes became a major focus of many Red Cross and Red Crescent National Societies in the post-1945 period, and the League emerged as a leading authority in the field. It did so by becoming a hub of expertise and assistance for its member National Societies as well as leveraging its growing global network of National Societies and partnerships with international organisations such as the WHO. The chapter explores the 1974 World Red Cross Day which focused on the promotion of voluntary, unpaid blood donation. It examines how the World Red Cross Day fed into a longer-term campaign to combat the commercialisation of blood donation, curtail the foreign trade in blood and blood products, and establish voluntary donation as the norm for quality blood transfusion services.

Blunt and penetrating trauma are common in many disasters, including hurricanes. Injured patients can present to the hospital during the event or up to several days after. Patients often present with lacerations and abrasions, but well-appearing patients still require a thorough physical exam and appropriate imaging with necessary consults. During disasters, patients can overwhelm the hospital and traditional imaging modalities (CTs); therefore, ultrasound can assist in patient triage and diagnoses during these times while accelerating patient care.

This case focuses on the response to traumatic asphyxiation following a stampede at a county fair, leading to the compression of a 26-year-old female against a wall. The scenario highlights the need for rapid trauma assessment in a resource-limited rural hospital with limited critical care capacity. The patient presents with respiratory distress, diminished lung sounds, bruising, and petechiae, consistent with traumatic asphyxiation. Key interventions include airway management, intubation, placement of chest tubes, and initiation of blood transfusion to manage her respiratory and hemodynamic status. The patient also shows signs of a hemothorax, necessitating emergency interventions and stabilization before transfer to a trauma center. The case emphasizes early recognition of traumatic asphyxiation, resource management, and coordination with higher levels of care, while also addressing the complexities of triaging additional patients from a mass casualty event.

Is it ethically justifiable to honor a patient’s request for ongoing blood transfusions for an incurable, relapsed leukemia, particularly in the context of scarcity? Our patient was a thirty-two-year-old Black man who had been hospitalized for six months. Despite daily blood and platelet transfusions, he remained too frail for cancer-directed therapy or discharge home. The clinical team considered ongoing transfusions to be a futile endeavor, especially given their state’s acute shortages of blood products. For the patient however, these transfusions were anything but futile: they were a form of life support, akin to hemodialysis, that allowed him to spend as much time as possible with his young family.

While this case initially appeared relatively straightforward using a utilitarian approach, the consultants have been haunted by our eschewing of alternative viewpoints, particularly in the context of the patient’s race and socioeconomic status. Should we have set aside our “usual commitments to professional polish and position” in favor of a more robust appreciation of the ethical, social, cultural, and economic dimensions of this case? By ignoring or downplaying important social considerations and our patient’s unique attributes, we actually may have tipped the balance towards less fairness and equity.

Blood transfusion may be required in the perioperative period for patients who have lost or actively losing blood. In order to manage this scenario, it is essential you know the patient’s circulating blood volume (based on their weight and age) and be able to estimate how much blood has been lost, which is not always straightforward, as some blood loss may be concealed. A blood loss of less than 10% of total blood volume does not usually require a transfusion; blood loss of greater 30% of total blood volume invariably requires transfusion.

Laboratory and/or point of care testing can be invaluable to guide to both blood transfusion and other blood components such as FFP platelets. Every hospital will have a major haemorrhage protocol.

There are many complications associated with blood transfusion including fever, hypothermia, circulatory overload and lung injury, immunological reactions, acid–base disturbances, hyperkalaemia and hypocalcaemia. In addition, infections may be transmitted such as HIV and hepatitis. Finally a serious error is to transfuse the wrong blood to a patient caused by errors including blood bottle mislabelling, or not checking the blood against the patient’s wristband.

Placenta previa is a common and potentially life-threatening complication of pregnancy. Transvaginal ultrasound is the best method for diagnosis, and delivery should be via cesarean delivery. Women with uncomplicated placenta previa should be delivered at 36–37 weeks. Antepartum bleeding is a common presentation, during which maternal stabilization is paramount, followed by a decision for delivery based on the maternal and fetal clinical statuses. Placenta previa is also a risk factor for placenta accreta syndrome and should be considered at time of delivery. Postpartum hemorrhage is also common in these deliveries, and various techniques can be employed to diminish the blood loss, including uterotonics, uterine artery embolization, intrauterine balloon, and hysterectomy. Proper identification of blood loss at every stage and proper utilization of blood products is essential to good outcomes.

Intravenous fluids are routinely given to children when the enteral route is not sufficient or it’s not an option, such as during surgery and anaesthesia. Lack of understanding of the composition of fluids and the appropriate rate to administer them has been associated with serious morbidity and mortality in children. Recent evidence has shown that giving children isotonic fluids with a sodium concentration similar to plasma decreases the risk of hyponatraemia without an increase in adverse effects. This has led to a change in guidelines, which now recommend that isotonic fluids are used in children along with regular monitoring of fluid balance and electrolytes. Current evidence supported by several anaesthesia societies across the world recommend that children are allowed and should be encouraged to drink clear fluids up to one hour before elective surgery. Evidence is starting to emerge from enhanced recovery programmes in children of improved outcomes from individualised perioperative fluid therapy and avoidance of prolonged preoperative fasting. Strategies to reduce blood transfusion in children having surgery include treatment of preoperative iron deficiency, acceptance of low transfusion thresholds, cell salvage and tranexamic acid administration.

Upper gastrointestinal bleeding (UGIB) is bleeding proximal to the ligament of Treitz (esophageal, gastric or duodenal source). More common than lower gastrointestinal bleeding (LGIB; approximately 70% of GIB). Most common cause is peptic ulcer disease. LGIB is bleeding distal to the ligament of Treitz. Lower gastrointestinal bleeding is less common than UGIB (approximately 30% of GIB). LGIB has lower mortality rate than UGIB. The most common cause is diverticular disease.

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism

Overview of cardiac complicationsincluding arrhythimias, heart failure, acute coronary syndrome, disseminated intravascular coagulation, hyperviscosity syndrome, and pulmonary embolism