The need for Intra-operative cell salvage training to reduce the use of Allogeneic ‘bank’ Blood during Surgery. Is the routine adoption of a competency-based assessment in Intra-operative cell salvage required?

Abstract

We performed a survey of all specialist registrars and their equivalents in the Imperial (North West Thames) region to assess their experience of and training in Intra-operative red cell salvage (ICS) and asked whether they would be confident to use ICS unsupervised for emergency out of hours work. 85% of respondents said that they would not be confident to set up or use ICS unsupervised.Allogeneic blood transfusion is expensive, associated with uncommon but potentially severe adverse consequences and of limited availability. Intra-operative red cell salvage (ICS) is a well-tried, cost effective method of reducing the use of allogeneic blood. Many organisations including the UK Blood Transfusion and Tissue Transplantation Service (www.transfusionguidelines.org) and the Association of Anaesthetists of Great Britain and Ireland have advocated the use of ICS for all suitable cases [1]. An operating department assistant (ODA) or anaesthetic nurse, with the appropriate experience, may set up the equipment but it will have to be supervised and used by an anaesthetist or, in a cardiac theatre, a Perfusionist. Anaesthetists with appropriate training and experience are therefore necessary if use of ICS is to be maximised. Allogeneic blood transfusion is expensive, associated with uncommon but potentially severe adverse consequences and of limited availability. Intra-operative red cell salvage (ICS) is a well-tried, cost effective method of reducing the use of allogeneic blood. Many organisations including the UK Blood Transfusion and Tissue Transplantation Service (www.transfusionguidelines.org) and the Association of Anaesthetists of Great Britain and Ireland have advocated the use of ICS for all suitable cases [1]. An operating department assistant (ODA) or anaesthetic nurse, with the appropriate experience, may set up the equipment but it will have to be supervised and used by an anaesthetist or, in a cardiac theatre, a Perfusionist. Anaesthetists with appropriate training and experience are therefore necessary if use of ICS is to be maximised.