Patient blood management for the perioperative setting: Why do we need patient blood management guidelines in the perioperative clinical area?

Patient blood management (PBM) is not a new concept; it has been a process of individualised care for patients for many years. Worldwide the Jehovah Witness population has been the forefront for the 'three pillars' of PBM. It is testimony to this as a community that health care professionals can always optimise what is the most valuable blood: the patient's own. PBM should be the standard of care for all and not just care we introduce when someone refuses blood products. There is a need to avoid unnecessary exposure to blood products, rather than the default of transfusing patients; if we do this, evidence suggests we may be able to reduce length of stay, reduce risk of postoperative infection and overall improve clinical outcomes for surgical patients.