Abstract
Introduction: Many elective surgical procedures requires transfusion due to anticipated blood loss,. The preoperative demand for blood is often an over-assumption as shown by the Blood Bank Records. This results in pre-emptive cross matching which renders a blood bag unavailable to other recipients thereby increasing the expiration of blood products and also causes overburdening of blood bank personnel, wastage of blood bank resources and time. The main aim of this present study is to improve the utilization of blood and to reduce the wastage of blood bank resources by adopting “Type and screen” (T&S) policy in departments with low transfusion probability.
Materials and Methods: Case records of all patients who underwent both elective and emergency surgeries in general surgery, gynecology and orthopedics were collected for a period of one year from 01 April 2016 to 31 March 2017 in our tertiary care institution. Transfusion parameters such as the number of units transfused, cross-matched were analysed. The calculated indices included Cross-Match to Transfusion Ratio (C:T ratio),Transfusion Probability (%T) and Transfusion Index (TI).
Results: It was observed that the transfusion probability in General surgery cases was high compared to gynecology and orthopedics.
Conclusion: Adoption of T&S policy over the Standard Blood Order Schedule (SBOS) for departments with low transfusion probability resulted in reduction of CT ratio, thereby improving the efficiency of the blood bank.
Keywords: Type & Screen, Transfusion probability, Surgery, Standard Blood Ordering Schedule,.
References
1. BhutiaSG, Srinivasan K, Ananthakrishnan N, Jayanthi S, Ravishankar M. Blood utilization in elective surgery-requirements, ordering and transfusion practices.Natl Med J India.1997;10:164-8
2. Friedman BA, H.A. Oberman, A.R.Chadwick, K.I. Kingdon. The maximum surgical blood order schedule and surgical blood use in the United States. Transfusion. 1976; 16(4): 380-387
3. Sakurai Y, Okada C. Comparison by simulation of the efficiency of surgical blood order equation with that of maximum surgical blood order schedule. Masui.2001;50:69-75.
4. PK Gupta, Harsh Kumar, RN Diwan. Blood ordering strategies in the armed forces-A proposal. Medical Journal, Armed Forces India.59(4):302-305.
5. Nuttal GA, Santrach OJ, Oliver WC, Ereth MH, Horlocker TT, CabanellaME,et al. Possible guidelines for autologous red blood cell donations before total hip arthroplasty based on the based on the surgical blood order equation. Mayo Clin Poc.2000;75:10-17
6. Arulselvi Subramanian, Kanchana Rangarajan et al, Reviewing the blood ordering schedule for elective orthopaedic surgeries at a level one trauma care centre, Journal of emergencies, Trauma And Shock,3(3):225-230
7. Vibhute M, Kamath SK, Shetty A et al. Blood utilization in elective general surgery cases: Requirements, ordering and transfusion practices. J Postgraduate Med.2000;46:13-17
8. Kumari S .Blood transfusion practices in a tertiary care center in Northern India, ,Journal of Lab Physicians. 2017 Apr-Jun; 9(2): 71–75.
9. Babita Raghuwanshi, NK Pehlajani, Mithilesh K Sinha and Swagata Tripathy A retrospective study of transfusion practices in a Tertiary Care Institute,Indian J Anaesth. 2017 Jan; 61(1): 24–28.
10. Arulselvi Subramanian, Sushma sagar, Subodh Kumar, Deepak Agarwal, Venecia Albert, Mahesh Chandra Mishra. Maximal surgical blood ordering schedule in a tertiary trauma centre in northern India : A proposal. Journal of Emergencies, Trauma and shock. 2012 Oct-Dec;5(4):321-7.
11. Alghamdi S, Gonzalez B, Howard L, Zeichner S, LaPietra A, Rosen G, Garcia G, Lamelas J, Goldszer R. Reducing blood utilization by implementation of a type-and-screen transfusion policy a single-institution experience. Am J Clin Pathol. 2014 Jun;141(6):892-5.
12. Agrawal A. Type and screen policy: is there any compromise on blood safety? Transfus Apher Sci. 2014 Apr;50(2):271-3.
13. Chow EY1.The impact of the type and screen test policy on hospital transfusion practice. Hong Kong Med J. 1999 Sep;5(3):275-279
14. Patten E, Alperin JB. Type and screen: a safe and effective preoperative blood ordering policy with emphasis on its use in obstetrics and gynecology. Am J Obstet Gynecol. 1982 Mar 1;142(5):563-567.
15. Pathak S, Chandrashekhar M, Wankhede GR. Type and screen policy in the blood bank: Is AHG cross-match still required? A study at a multispecialty corporate hospital in India. Asian J Transfusion Sci. 2011 Jul;5(2):153-6.
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.107
