A prospective study was carried out for 6 months to determine the efficacy of blood ordering routines for elective surgery. It was found that only 23% of procedures needed preoperative crossmatching of blood (transfusion index ‘IT’ >0.5). There was an excessive over-ordering of blood for 77% of the operations (crossmatch/transfusion ratio >2.5). In addition, the transfusion index for the latter group showed that there was no need to prepare blood preoperatively (TI <0.5).
A transfusion tariff is worked out which abandons crossmatching for the majority of procedures (cholecystectomy, thyroidectomy and surgery for duodenal ulcer excluding gastrectomy). Instead a ‘group and screen’ policy is suggested.
MeadJ., AnthonyC.D., SattlerM.Hemotherapy in elective surgery. An incidence report, review of the literature and alternatives for guideline appraisal. Am J Clin Path1980; 74: 223–7
4.
SeshadriR.S., O'DellW.R., RoxbyD., MorleyA.A.Effective use of blood in elective surgery. Med JAust1979; 2: 575–8
5.
ArgovS., ShechterY.Is routine crossmatching for two units of blood necessary in elective surgery?Am J Surg1981; 142: 370–1
6.
BoralL.I., DannemillerF.J., StanfordW., HillS.S., CornellT.A.A guideline for anticipated blood usage during elective surgical procedures. Am J Clin Pathol1979; 71: 680–4
7.
FriedmanB.A.An analysis of surgical blood use in United States Hospitals with application of the maximum surgical blood order schedule. Transfusion1979; 19: 268–78
8.
PathiV.L., GhoshiS., CuschieriA.Its Scotland's blood, so why waste it?J R Coll Surg Ed1987; 32: 69–71
9.
NapierJ.A.F., BiffinA.H., LayD.Efficiency of use of blood for surgery in south and mid Wales. Br Med J1985; 291: 799–801
10.
LeeK.Lachance V. Type and screen for elective surgery. Results in one year experience in a small community hospital. Transfusion1980; 20: 324–6
11.
DadsworthH., DudleyH.A.F.Increased efficiency of transfusion practice in routine surgery using preoperative antibody screening and selective ordering with an abbreviated crossmatch. Br J Surg1985; 72: 102–4
