CHAPTER 93 ■ HEMATOLOGIC EMERGENCIES STACY E CROTEAU, ERIC W FLEEGLER, MARISA B BRETT-FLEEGLER GOALS OF EMERGENCY THERAPY The management of pediatric hematologic emergencies is directed toward immediate stabilization of the acutely ill patient to prevent morbidity and mortality related to severe anemia, infection, bleeding, and thrombosis Profound anemia requires simultaneous hemodynamic stabilization and elucidation of the underlying etiology Patients at risk for infection and sepsis, such as neutropenic or asplenic patients, require prompt attention; quality metrics focus on time to initiation of antibiotic therapy for these patients Significant hematologic findings of unknown etiology require thorough evaluation, especially where necessary therapies may obscure the underlying diagnosis or impede later diagnostic testing Hematologic emergencies arise in children who have been previously well, who have known blood disorders, or who have systemic disease Initial measures of support, diagnosis, and treatment are based on general principles that often not require a definitive diagnosis to initiate management KEY POINTS