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Year : 2011  |  Volume : 1  |  Issue : 1  |  Page : 33-37

Surgical Blood Ordering System in Al-Yarmouk Teaching Hospital; Lessons to Learn from the Results Based on the Cross-matched Transfused Ratio

1 Iraqi Red Crescent Society, Iraqi Red Crescent Maternity Hospital
2 Al-Yarmouk Teaching Hospital, Teaching Laboratories Department, Hematology Unit

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Source of Support: None, Conflict of Interest: None

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Background: The primary purpose of transfusion medicine is to provide safe and effective blood and its components on need. New procedures to reduce unnecessary work load are vital to improve the efficiency of blood transfusion services, therefore, the introduction, reappraisal and rationalization of the surgical blood order schemes are important developments in this respect. Aim of the study: To audit the surgical blood ordering system adequacy in Al-Yarmouk Teaching Hospital in comparison to the defined Cross-matched: Transfused (C:T) ratio standards of the Maximum Surgical Blood Ordering Schedule (MSBOS). Methods: This study was conducted retrospectively in Al-Yarmouk Teaching Hospital blood transfusion center for the years 2008 and 2009 to evaluate the elective surgical blood ordering system in this hospital which is totally based on the surgeon's decision, i.e., patient-specific blood ordering schedule (PSBOS). All whole blood units cross matched and all whole blood units' transfusion for elective surgical procedures using the major cross match technique were included. Results: The amount of blood crossmatched (C) were 14780 units, the amount of blood transfused (T) were 11930 units , and the C:T blood ratio was 1.24:1.The sensitivity, specificity, positive predictive value and negative predictive value of the PSBOS are 98.9%, 75.8%, 80.7% and 98.6% respectively. Conclusions: The quite clear success of patient-specific blood ordering system (PSBOS) over the maximum surgical blood ordering schedule (MSBOS) in reducing work load in Al-Yarmouk Teaching Hospital blood transfusion center entitles the continuation with its application. However, this system needs to be periodically audited because its success may be at least partially explained by that the surgeons are underestimating the expected need for blood transfusion in elective procedures and that the transfusions were not all medically justifiable.

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