Blood ordering protocol based on proposed surgical implant in fractured neck of femur patients

INTRODUCTION: Fractured neck of femur patients frequently require blood transfusion. To improve the efficiency of blood ordering, we present a protocol which orders blood specific for the proposed surgical implant. PATIENTS AND METHODS: A retrospective audit over a 1-year period was performed. Patients were divided into six groups dependent on proposed surgical implant. The mean postoperative drop in haemoglobin concentration, the cross-match to transfusion ratio and transfusion indexes were calculated. RESULTS: Statistically significant differences in blood loss were found dependent on implant used. Using guidelines created by the British Committee for Standards in Haematology on the implementation of a maximum surgical blood ordering schedule, a new protocol for blood ordering based on proposed surgical implant was created. CONCLUSIONS: In fractured neck of femur patients awaiting operation, the type of implant can be used to anticipate blood loss and as a guide to blood ordering.