The increasing success reported in the use of rFVIIa to control severe bleeding in surgery and trauma in hemophilia and non-hemophilia patients has made it necessary to formulate protocols and guidelines which may be followed in managing such patients. This is an excellent paper by transfusion medicine service at Washington University School of Medicine which developed educational guidelines and policy recommendations for the use of rFVIIa, based on review of the literature and their own experience. The use of the drug required approval by transfusion medicine service and a formal hematology consult to assist in the management. The guidelines cover various indications and precautions, and is a very useful template for other institutions.

– Maadh Aldouri