The need to prepare a treatment manual In 2005, "Medicinal preparations made from human blood" was published in Estonia the Estonian guide to the use" (1), the purpose of which was to provide the first a more comprehensive overview in Estonian of the state-of-the-art in the use of blood preparations principles. This guide has helped create a theoretical foundation for all patients to ensure a consistent quality of transfusion therapy, but as the guideline authors point out, the point of departure for this guide is the remedy, not the condition. Bearing in mind that in other parts of the world, the patient's blood has started to be followed more and more there is a need to prepare the concept of patient blood management a new treatment guide introducing the use of transfusion therapy from the patient and based on his medical conditions. The concept of the patient's blood is based on the evidence of modern transfusiology a multidisciplinary concept that seeks to optimize the need for blood transfusion patient treatment. When making a treatment decision, the patient, whose conserving one's own blood is paramount, and a clinical outcome is sought without unnecessary transfusion of blood components. To date, the patient's blood perception program implemented in many countries, e.g. Australia, Great Britain, in the United States, Germany, etc. The guideline aims to emphasize the importance of preoperative assessment and performing analyzes and, if necessary, correcting the patient's treatment so that reduce the number of patients receiving blood transfusions. Anemia, acute bleeding and blood transfusion are three independent risk factors affecting the patient treatment outcome unfavorably. The mortality rate of patients receiving blood transfusions is higher and morbidity (including occurrence of cardiac, renal, respiratory and wound complications) more frequent, the duration of hospitalization is longer, and the need for intensive care and treatment costs are higher higher than in patients who did not receive a blood transfusion in the same condition. The updated treatment manual provides an opportunity to evaluate the practice of transfusion therapy on the same basis throughout the country, analyze it, correct it if necessary and to lead. Together with the guide, it is published in cooperation with SA Põhja-Eesti Regionalhaigla Updated additional material on blood components prepared by the Blood Center specifications and additional materials prepared by the Estonian Society of Anesthesiologists 10 on the treatment of antithrombotic drugs in scheduled surgery and emergencies in situations. Treatment area and target group of the treatment manual The treatment guide describes a patient with anemia and/or bleeding risk pre-operative diagnostics and outpatient treatment and diagnostics and treatment of patients with acute bleeding, including massive transfusion. Also emergency transfusion treatment related to obstetric care and the need to check all patients who have undergone acute blood loss in the future improvement. The treatment manual is mainly intended for emergency use