Don’t perform routine preoperative hemostatic testing (PT, aPTT) in an otherwise healthy child with no prior personal or family history of bleeding.
|Rationale and Comments:||Preoperative hemostatic screening in healthy pediatric patients with no personal or family history of excessive bleeding does not effectively identify those who will have unexpected surgical bleeding. Artifacts or disorders that do not affect bleeding risk may be identified, such as factor XII deficiency or an infection-associated, transient lupus anticoagulant. Hemostatic testing adds cost and may introduce additional stress, either due to blood sampling or if a child has “abnormal” results.|
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