BSOA - British Society of Orthopaedic Anaesthetists

In our institution, prior to 2005, all primary hips, knees, shoulders, elbows and ankle replacements were crossmatched 2 units of blood, and revisions of these joints were cross-matched 4 units.

Three sequential audits showed few units were given on the day of operation. Units were often used to ‘top up transfuse’ patients post-operatively. The blood ordering guidelines were progressively modified, in light of these findings.

Our current guidelines are now for all primary replacements to be grouped and saved only (chronically anaemic patients and revision hips are crossmatched 2 units). The Orthopaedic Directorate is not aware of significant problems with this policy.

We assessed the possible outcome of the new blood ordering guidelines.