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Chapter 18
Consultative hematology
The role and effectiveness of the consultant
A hematology consultant provides expert advice to requesting physicians and other health care providers about the diagnosis and management of benign or malignant hematologic disorders. A consultation request might involve an adult general medical patient, a child or adolescent, a pregnant woman, a perioperative patient, or an individual who is critically ill. Within a health care community, the hematologist might also be asked to serve as a specialty consultant on committees that maintain a formulary, develop clinical practice guidelines, establish policies and procedures for transfusion services, or monitor quality and efficiency. Although these latter roles will not be specifically addressed
Consultation for surgery and invasive procedures
Preprocedure assessment for bleeding risk Perioperative hemorrhage, hemostatic agents, and transfusion Intraoperative hemorrhage Hemostatic agents Transfusion Postoperative bleeding Thromboprophylaxis and postoperative thrombosis Prophylaxis for thromboembolism Treatment of postoperative deep venous thrombosis
Intensive care unit
Anemia Thrombocytopenia Drug-induced thrombocytopenia Infection and disseminated intravascular coagulation Massive transfusion-induced thrombocytopenia Thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome Catastrophic antiphospholipid antibody syndrome Platelet transfusion
Consultation for hematologic complications of solid-organ transplantation
Transfusion support Posttransplant lymphoproliferative disorders Drug-related abnormalities Alloimmune complications
Obstetrics and gynecology
Anemia Thrombocytopenia von Willebrand disease Thrombophilia and thromboembolism during pregnancy Thrombophilia, fetal loss, and poor pregnancy outcomes Artificial heart valves Hematologic malignancies
Selected outpatient hematology topics
Mild thrombocytopenia Leukocytosis Leukopenia Atypical lymphoproliferative processes Lymphadenopathy Autoimmune lymphoproliferative syndrome Castleman disease Splenomegaly
Consultation in pediatric patients
Anemia in the newborn Neutropenia in the newborn Thrombocytopenia in the newborn Coagulopathy in the newborn Thrombosis in the newborn ITP in children Lupus anticoagulants in children | |||||||||||||||||||||||||||||||||||||||||||||||||||