Transfusion
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The majority of fresh-frozen plasma (FFP) is transfused in the United States in the management of acquired bleeding disorders. The prothrombin time (PT), and its derivative the international normalized ratio (INR), is the most common test used to detect the presence and gauge the severity of these disorders. Observation studies have shown that the PT correlates poorly with clinical bleeding and that transfusion of plasma often achieves no measurable change in the INR nor is of any known clinical benefit. ⋯ A program of engagement and interdiction using evidence-based guidelines can successfully decrease the use of FFP without any observable increase in unexpected bleeding.