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Anemia, Emergency Medicine

Stevan A. Vuckovic and Paul J. Allegretti Reviewed 06/2017



  • Reduction below normal in the mass of RBCs

  • Measured by 1 or more of the major RBC components:

    • Hemoglobin (Hgb): Concentration of the major oxygen-carrying component in whole blood

    • Hemat...


Signs and Symptoms

Depends on: 
  • Rapidity of onset:

    • Hypovolemia if acute

    • Asymptomatic if mild and chronic


  • Underlying disease

  • Severity and type of anemia

  • Fatigue

  • Decreased exercise intolerance

  • S...



Ongoing blood loss requires close assessment and rapid transport: 
  • Control bleeding to include wound packing and use of tourniquets if needed.

  • Two large-bore IVs

Initial Stabilization/Therapy



Admission Criteria

  • Unstable vital signs

  • Ongoing blood loss

  • Symptomatic anemia—angina/dyspnea/syncope/neurologic symptoms

  • Need for transfusion

  • Need for aggressive evaluation

  • Severe anemi...

Pearls and Pitfalls

  • Anemia is an indication of an underlying disorder or deficiency.

  • Severe or life-threatening cases require immediate correction via blood transfusion.

  • Most cases seen in the ED are ch...

Additional Reading

  • Bryan  L, Zakai  N. Why is my patient anemic? Hematol Oncol Clin N.  2012;26:205–230.

  • Bunn  HF. Goldman: Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders, an impr...



  • 280.0 Iron deficiency anemia secondary to blood loss (chronic)

  • 285.1 Acute posthemorrhagic anemia

  • 285.9 Anemia, unspecified

  • 283.9 Acquired hemolytic anemia, unspecified

  • 285.29 Anemia of other ch...

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