NHSBT amber alert and use of tranexamic acid

NHS Blood and Transplant (NHSBT) triggered an ‘amber alert’ on 12 October, meaning hospitals have been asked to put in place management plans to protect blood stocks.  

In line with the measures requested by NHSBT, we recommend that use of tranexamic acid is considered in all adult surgical patients and administered if more than 500ml of blood loss is likely. We also recommend that theatre teams consider adding this prompt to the perioperative care theatre checklist process.

Results from the recent POISE-3 clinical trial confirm the quality, safety and cost-effectiveness of using tranexamic acid in surgery, where more than 500ml of blood loss is anticipated. This evidence further supports the NICE quality statement on blood transfusion and complements the recent Centre for Perioperative Care guideline Anaemia in the Perioperative Pathway.

Increasing the use of tranexamic acid in this way may reduce the risk of cancelling elective surgery because of limited availability of blood stocks.

Please share this with your colleagues, especially those in your perioperative, surgical and anaesthetic departments.

Dr David Selwyn
Director, Centre for Perioperative Care

Dr Fiona Donald
President, Royal College of Anaesthetists

Dr Sarah Clarke
President, Royal College of Physicians

Professor Neil Mortensen
President, Royal College of Surgeons of England