Development and evaluation of a new paediatric blood transfusion protocol for Africa

Severe anaemia is a common childhood emergency in developing countries. Practical evidence-based guidance on when to transfuse, volume of transfusion and ideal duration of transfusion is lacking. The aim of this study is to develop a paediatric transfusion protocol for use in under-resourced environments and evaluate its usability in a busy African hospital setting. A paediatric transfusion protocol based on the WHO Guidelines was developed for the Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi. On the basis of simple bedside clinical features of respiratory, cardiovascular and neurological compromise, the protocol allocates children with severe anaemia (haemoglobin