Red Blood Cells & Autologous Blood:

1. Active bleeding with estimated blood loss 30% or more
2. Active bleeding with one or more signs of volume depletion:
   • Pulse over 100 
   • Weakness 
   • Systolic BP under 90 
   • Shortness of Breath-Vertigo
3. Non-bleeding patient with one or more of the following:
   • HGB = 7 g/dL or below
   • HCT = 21 or below
4. Symptomatic Anemia with one or more of the following:
   • Less than ordinary activity 
   • fatigue 
   • Palpitations 
   • Dyspnea 
   • Anginal Pain
5. Refractory Anemia
6. Anemia with Systemic disease

Whole Blood:

1. Liver Transplants
2. Exchange transfusion for Neonates

Platelets:

1. Non-bleeding patient, platelet count of 20,000 or below.
2. Platelet counts below 50,000 with one or more of the following:
   • Hemorrhage 
   • Invasive Procedure 
   • Surgical Procedure
3. Abnormal Platelet function

Frozen Plasma:

1. Surgical Patient with documentation of one or more of the following:
   • Generalized bleeding non-controlled by surgical hemostasis
   • INR greater than 1.3 and at risk for CNS bleed
   • INR greater than 1.5 and actively bleeding
   • INR greater than 1.5 and anticipated surgery or invasive procedure
2. Congenital deficiencies, Factors II, V, VII, IX, X XI, XII with one or more of the following:
   • Bleeding          
   • Impending invasive procedure
3. Correction of effects of Coumadin with presence of one or more of the following:
   • Actively bleeding
   • Emergency surgery within 6 hours
4. DIC and FIB levels above 100mg/dL

Cryoprecipitate:

1. Active bleeding with fibrinogen level below 100mg/dL and:
   • actively bleeding
   • anticipated surgery or invasive procedure
2. Documented Von Willebrands Disease
3. Fibrin Sealant
4. DIC
5. Hemophilia with bleeding
6. Unresponsive to DDVAP and no appropriate factor concentrates available.
7. End stage liver disease or uremia with bleeding unresponsive to DDAVP

Irradiated Blood and Blood Components

1. Patients with:
   • leukemia
   • non-Hodgkin lymphoma
   • neuroblastoma or glioblastoma
   • Hodgkin’s Disease
2. Patients undergoing intensive chemotherapy or immunosuppressive therapy.
3. Bone marrow transplant recipient.
4. CLL patients being treated with flurdarabine.
5. Recipients of HLA matched platelets.
6. Patients with congenital immunodeficiency syndromes.
7. Intrauterine transfusions
8. All neonate transfusions
9. All designated donations (including those by a blood relative).

Whole Blood and Red Blood Cells

1. Treatment of anemia that can be corrected with specific medications such as iron, vitamin B12, folic acid, or erythropoietin.
2. Volume expansion or to increase oncotic pressure of circulating blood.

Plasma

1. When vitamin K , cryoprecipitate, of Factor VIII concentrates are more effective.
2. Volume expansion when other expanders may be used  safely and adequately replace the volume.

Cryoprecipitate
Do not use this product unless laboratory studies indicate a specific hemostatic defect for which this product is indicated.

Platelets

1. Bleeding is unrelated to a decrease in numbers of platelets or abnormally functioning platelets.
2. With the endogenous destruction of platelets caused by TTP or ITP, unless the patient has a life-threatening hemorrhage.