Enhanced strategies for prevention and management of blood loss in special, unusual, and unexpected surgical situations.

Typically, surgical and anesthesia teams work together in the operating room to control blood loss by thoroughly evaluating bleeding risk preoperatively and by using their training in the treatment of intraoperative blood loss. As a result, most bleeding is usually well controlled. In many cases a hematologist is consulted for recommendations preoperatively or, in urgent situations, even while the patient is in the operating room. In the end, however, it is usually the surgeons and anesthesiologists making decisions about how best to control bleeding. What follows is an update on currently available options in the management of surgical bleeding (Table 1).