Red blood cells contain hemoglobin, the primary carrier of oxygen throughout the human body. When hemoglobin levels decrease, anemia results and patients may exhibit signs and symptoms of decreased oxygen delivery to tissues (also known as oxygen debt). The signs and symptoms of oxygen debt may include tachycardia, dyspnea, fatigue, chest pain, and altered mental status. Laboratory findings may include metabolic acidosis, hyperlactatemia, and elevated cardiac enzymes. Transfusion of packed red blood cells is administered to anemic patients who are symptomatic to relieve the signs and symptoms of oxygen debt. However, some patients are unable to receive blood transfusions due to religious beliefs or medical reasons. In these patient populations, hyperbaric oxygen therapy can be administered to increase oxygen delivery to tissues and relieve the signs and symptoms of oxygen debt. This activity highlights the interprofessional team's role in managing patients with anemia who refuse blood transfusions.

​Awareness of HBO for blood loss anemia is low, as is access to capable HBO facilities.[16] Increased awareness and a willingness to transfer to an HBO-capable site can benefit anemic patients who refuse blood transfusions. They can be managed by an interprofessional team that includes clinicians, nurse practitioners and physician assistants, respiratory therapists, hyperbaric technicians, hematologists, nurses, and pharmacists. Patients should be educated that there is a potential for death without blood. Some patients may benefit from HBO therapy, but this requires multiple sessions. However, the treatment is relatively safe and cost-effective, comparable in cost with a unit of packed red cells.[8] {harmcists can provide medication reconciliation and monitor the dosing of hematinic agents, which nurses will usually administer.