Blood utilisation in elective general surgery cases: requirements, ordering and transfusion practices

For elective surgeries, over ordering of blood is a common practice. This can be decreased by simple means of changing the blood cross matching and ordering schedule depending upon the type of surgery performed. The principle aim of the study was to improve the efficacy of ordering system for maximum utilisation of blood and formulation of maximum surgical blood order schedule (MSBOS) for procedures where a complete cross-match appears mandatory.

We evaluated blood ordering and transfusion practices in 500 elective general surgical procedures at our institute. With the help of different indices such as cross-match to transfusion ratio (C/T ratio), transfusion probability (% T) and transfusion index (TI), blood ordering pattern was changed in the next 150 patients.

Out of 1145 units of blood crossmatched for the first 500 patients only 265 were transfused with non-utilisation of 76.86% of ordered blood. With the help of the indices the wastage was reduced in next 150 patients, i.e. from 76.86% to 25.26% and improved the utilisation of blood, i.e. from 23.14% to 74.74%.

Change of blood ordering patterns with use of MSBOS can avoid the over ordering of blood.