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J R Soc Med. 1990 June; 83(6): 368–370.
PMCID: PMC1292686

Blood ordering habits for elective surgery: time for change.


A prospective study was carried out for 6 months to determine the efficacy of blood ordering routines for elective surgery. It was found that only 23% of procedures needed preoperative crossmatching of blood (transfusion index 'TI' greater than 0.5). There was an excessive over-ordering of blood for 77% of the operations (crossmatch/transfusion ratio greater than 2.5). In addition, the transfusion index for the latter group showed that there was no need to prepare blood preoperatively (TI less than 0.5). A transfusion tariff is worked out which abandons crossmatching for the majority of procedures (cholecystectomy, thyroidectomy and surgery for duodenal ulcer excluding gastrectomy). Instead a 'group and screen' policy is suggested.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
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  • Friedman BA. An analysis of surgical blood use in United States hospitals with application to the maximum surgical blood order schedule. Transfusion. 1979 May-Jun;19(3):268–278. [PubMed]
  • Pathi VL, Ghosh S, Cuschieri A. It's Scotland's blood, so why waste it? A survey of blood ordering habits in the Tayside Region. J R Coll Surg Edinb. 1987 Apr;32(2):69–71. [PubMed]
  • Napier JA, Biffin AH, Lay D. Efficiency of use of blood for surgery in south and mid Wales. Br Med J (Clin Res Ed) 1985 Sep 21;291(6498):799–801. [PMC free article] [PubMed]
  • Lee K, Lachance V. Type and screen for elective surgery. Results of one year's experience in a small community hospital. Transfusion. 1980 May-Jun;20(3):324–326. [PubMed]
  • Dodsworth H, Dudley HA. Increased efficiency of transfusion practice in routine surgery using pre-operative antibody screening and selective ordering with an abbreviated crossmatch. Br J Surg. 1985 Feb;72(2):102–104. [PubMed]

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