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Blood ordering protocol based on proposed surgical implant in fractured neck of femur patients.

Morritt DG, Morritt AN, Kelley SP, Stone MH

Department of Orthopaedics, The General Infirmary at Leeds, Leeds, UK. dan@danielmorritt.freeserve.co.uk

INTRODUCTION: Fractured neck of femur patients frequently require blood transfusion. To improve the efficiency of blood ordering, we present a protocol which orders blood specific for the proposed surgical implant. PATIENTS AND METHODS: A retrospective audit over a 1-year period was performed. Patients were divided into six groups dependent on proposed surgical implant. The mean postoperative drop in haemoglobin concentration, the cross-match to transfusion ratio and transfusion indexes were calculated. RESULTS: Statistically significant differences in blood loss were found dependent on implant used. Using guidelines created by the British Committee for Standards in Haematology on the implementation of a maximum surgical blood ordering schedule, a new protocol for blood ordering based on proposed surgical implant was created. CONCLUSIONS: In fractured neck of femur patients awaiting operation, the type of implant can be used to anticipate blood loss and as a guide to blood ordering.

Published 2 November 2005 in Ann R Coll Surg Engl, 87(6): 445-8.
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