The intraoperative transfusion of blood and blood products is associated with a number of significant cost and safety concerns. To address these concerns and to limit unnecessary transfusion, a variety of patient blood management (PBM) strategies are available, including the use of topical hemostatic agents. This study guide identifies concerns currently associated with intraoperative transfusion and describes effective PBM strategies, including the use of topical hemostatic agents. The importance of using a validated intraoperative bleeding scale to assess and compare the efficacy of these agents is emphasized.