The national stock of O D negative red cells is low and NHS Blood and Transport (NHSBT) and the National Blood Transfusion Committee (NBTC) are asking all hospital clinical teams to take the following actions now to avoid impacting on NHSBT’s ability to supply to orders:

•          Use of tranexamic acid prior to major surgery
•          Appropriate treatment of iron deficiency anaemia with oral or intravenous iron
•          Appropriate treatment of vitamin B12/folate deficiencies 
•          Single unit red cell transfusions if not actively bleeding or on a transfusion programme
•          Use a restrictive red cell transfusion threshold, haemoglobin of 70 g/L unless patient is bleeding, has acute coronary syndrome, or is on a chronic transfusion programme

Please refer to the NBTC Pre-Amber guidance and continue to implement the Patient Blood Management recommendations above. Thank you.