In this episode of The Pathology Report, host A/Prof Daniel Owens speaks with Dr Pratheepan Puvanakumar, a clinical and laboratory haematologist at Monash Health in Melbourne, and Prof Beverley Hunt, a consultant in thrombosis and haemostasis and clinical lead for haematological laboratory services at Guy's and St Thomas' NHS Foundation Trust in the UK, about critical developments in bleeding management. In their discussions, they explore practical approaches to bleeding management across obstetrics and trauma care settings.

Dr Puvanakumar shares insights on recent updates to Australian patient blood management guidelines, highlighting implementation challenges particularly affecting rural and remote healthcare providers. He emphasises the critical importance of effective communication protocols among clinicians during emergency bleeding scenarios.

Prof Hunt brings her UK perspective on major haemorrhage protocols, noting significant evidence gaps in current transfusion practices. She presents recent UK data on postpartum haemorrhage management, advocating for increased use of thromboelastography and fibrinogen monitoring to improve outcomes.

Discussions covered the practical aspects of bleeding management including:

• The implementation status of viscoelastic haemostatic assays
• Communication barriers in critical care environments
• Evidence-based approaches to transfusion practices
• Tranexamic acid use supported by CRASH-2 trial findings
• Special considerations for high-risk populations

Prof Hunt also highlights the compounded challenges facing low-resource settings where anaemia and bleeding risks intersect, emphasising the importance of nutritional support and affordable access to tranexamic acid.

This episode concludes with reflections on pathology service security following a recent UK cyber-attack that significantly disrupted hospital operations, underscoring the critical role of robust infrastructure in emergency care delivery.

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The Pathology Report is produced by the Royal College of Pathologists of Australasia and is part of the Talking HealthTech Podcast Network.

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