Treat the bleed: Tool connects clinicians and learners to best practices in bleeding management

Bleeding is a common scenario in hospital settings, but treating it can be complex. With many levels of expertise involved in managing bleeding, education is key. With this in mind, Dr. Ziad Solh, Assistant Professor and Medical Director of Transfusion Medicine, helped develop Treat The Bleed, an online, evidence-based resource for clinicians and learners that provides quick access to best practices in bleeding management.

We spoke to Dr. Solh about this resource and plans for additional modules.

What is the goal of Treat The Bleed?

The goal of Treat The Bleed (TTB) is to provide a quick and easy educational tool for clinicians and learners about bleeding conditions. It can be used as a quick review before seeing a patient, or for general studying purposes. It can be especially useful for front-line physicians in medical and surgical specialties.

How did Treat The Bleed come about?

TTB is a collaborative effort between Canadian physicians who are passionate about best practices in bleeding management.

It was initially focused on the reversal of bleeding related to a drug called warfarin. This is a commonly mismanaged condition leading to inappropriate transfusion of plasma, a precious resource from blood donors. For this reason, we wanted to educate clinicians about alternatives to plasma that are available in Canada.

Now, TTB is about much more than warfarin reversal; there are several bleeding conditions that have been identified as key areas in need of quick and easy access to educational material. TTB will provide a 'Top 10 Questions' type of approach to these complex and common scenarios.

Why is there a need for a resource like this?

Bleeding is a common and stressful scenario in the hospital especially after procedures and surgeries. Bleeding is often treated with blood transfusion, which is the most common hospital procedure but not always done appropriately. In fact, an audit showed that half of plasma used in hospitals is transfused for the wrong reason or at the wrong dose. Similar audits have shown poor red cell transfusion practices.

Because bleeding is such a complex topic, TTB can provide an easy evidence-based guide to help clinicians with making the correct decision in stressful situations.

What was your contribution and why did you decide to get involved?

As the Medical Director of Transfusion Medicine at London Health Sciences Centre and St. Joseph’s Health Care London, I have a responsibility to ensure best practices are implemented in bleeding management. Education is a key component of best practice implementation, especially when many levels of expertise are involved in the management of the bleeding scenario. The School’s trainees are almost always involved in these clinical scenarios.

I developed the content for TTB with my colleagues by conducting the literature review, developing the questions and answers, designing the visual aids, and disseminating the material to colleagues. It was a very creative and scientific process. Currently, we are working on other modules such as massive hemorrhage, DOAC reversal, and heavy menstrual bleeding.