For want of a bag of bloodBMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7231.365 (Published 05 February 2000) Cite this as: BMJ 2000;320:365
- Michael Yung, consultant paediatric intensivist
- Newcastle upon Tyne
I had been working in sub-Saharan Africa for a month, and it was the height of the malaria season. When I first arrived I asked what the transfusion threshold was, and was told, “A haemoglobin of 5 if they are sick; otherwise 3.5.” An otherwise perfectly normal little girl was admitted with a haemoglobin of 2.6 and malaria. Like any toddler, she was able to sit, look around, and resist examination. I tried to give her oxygen but, like most toddlers, she would not keep the mask on. However, she had the respiratory distress and metabolic acidosis of severe malaria, and needed blood urgently.
Most children with this life threatening syndrome did well with simple treatments: antimalarials, fluid, and blood. …