Blood Bank Staff Research Articles

Use of Blood in Elective Surgery: An Area of Wasted Hospital Resource

Unavailability of blood is a common cause of canceled operations but clinicians' blood ordering habits have been shown to waste hospital resources. A prospective audit was set up in a blood bank in a teaching hospital in Saudi Arabia. Data were separately logged on blood transfusion for all surgical operations between August 1991 and December 1992. Standard terminology was employed. During the 16 months, 565 consecutive operations were logged. Only two of eight departments met the criterion of efficient blood ordering, vis-a-vis a C:T ratio (units crossmatched divided by units transfused) of 2.5:1. Similarly, in the four most frequently performed operations, the transfusion index (Ti) was <0.25, indicating that blood would have been required for <25% of these cases. The study confirms others' experience of inefficiency in blood ordering for surgical operations, plus its attendant waste of resources. It is recommended that unless written and binding guidelines are published on a nationwide basis, clinicians' inefficient methods in ordering blood are unlikely to alter rapidly.

Is major surgery in hemophiliac patients safe?

AbstractIn the last 20 years, surgery in patients with hemophilia has been carried out with progressively less mortality and morbidity. Even extensive and major surgical operations can be carried out provided that the underlying coagulopathy is corrected and normal hemostasis restored.We report the results of 196 operations performed in 147 hemophiliacs during the period 1961–1985 in the Department of Surgery, Warsaw Institute of Hematology. Our patients experienced, in this 25‐year period, 23% of hemorrhagic complications in hemophilia A and 12.5% in hemophilia B. In the last 5 years, however, the incidence of hemorrhagic complications was reduced to 5.2% in hemophilia A and 8.3% in hemophilia B. This correlates with the discovery of cryoprecipitate and with the development of concentrates of factor VIII and IX, respectively.In all patients, deficient factor levels were determined before the operation. The replacement therapy was based on the policy of raising the level of factor VIII or IX above 60% of the normal value and maintaining this level above 30% in the postoperative period until final wound healing.Problems discussed in this article include the principles of replacement therapy, its advantages and disadvantages, and the organization and degree of cooperation among surgeon, hematologist, and blood bank staff.

Progress in transfusion therapy and treatment of bleeding problems in aortic aneurysm surgery.

AbstractBlood transfusion for extensive cardiovascular procedures differs from one center to another depending on the local donor supply and the regional philosophy of efficient utilization. Our initial experience was obtained with the exclusive use of whole blood, no other products being available. Some centers still rely heavily on this, or on modified whole blood. Others use a variable number of units of whole blood, followed by specific hemocomponents that may be limited in supply. Since 1976, we have used the specific component therapy approach to supply all patient needs, including those associated with cardiovascular surgery. Our success depends as much on surgical skill, teamwork, and excellent communication as on the rapid availability of an adequate supply of hemocomponents. When problems occur during or after operation, immediate consultation with the blood bank staff and the availability of excellent technical and consultative expertise in blood coagulation are invaluable in the rapid restoration of the jeopardized patient.

The Origins of Blood Bank Directors, Supervisors, and Staff for Military and Civilian Blood Bank Operations, Training, and Research

The Origins of Blood Bank Directors, Supervisors, and Staff for Military and Civilian Blood Bank Operations, Training, and Research

Hepatitis B surface antigen in the Iraqi population

Using counter immunoelectrophoresis (CIEP), the carrier rate of HBsAg among the Arab Population of Iraq was found to be 2·8% compared with 5·5% in the Kurd population. The incidence of antigenaemia in laboratory workers, renal dialysis staff and patients, nursing and blood bank staff, and pulmonary tuberculosis and diabetes mellitus patients is also reported. Study of immunoglobulin classes in carriers and in HBsAg-negative controls showed that raised IgG and IgM is more common in the former than in the latter.

Inventory control in hospital blood banks

The delicate relationship between donors and the Transfusion Service in the U.K. implies a clear duty to make the best possible use of the limited blood supplies, and this turns attention upon the stocking policies adopted by Hospital Blood Banks. Whereas Blood Bank staff can obtain an intuitive grasp of the effects of various stock levels for the common bloods, this is not usually the case for the rare bloods which are more difficult to control. A policy decision has to be made which balances the conflicting stock requirements of maintaining a high availability and also low out-dating rates. A Markovian structure is exploited in this paper for this purpose and the effects of the key variables are shown to be interrelated. In any particular instance the form of the probability distribution of demand between replenishments, the scale of the throughput, the blood life in relation to the ordering interval, the fraction of blood transfused and the fraction of the replenishment order which is supplied to the Bank will together determine the form of the operating characteristics.

Blood Bank Refrigerator Alarms: Improving Coverage and Preventing Trouble

Three alarm systems, one warning of temperatures above and below the acceptable range for blood preservation, the other two designed to prevent temperature rises due to unclosed refrigerator doors and power supply failure, are described and diagrammed. The temperature alarm gives its audible and visual signal in a constantly manned, distant area, identifies the refrigerator which failed, automatically signals the restoration of proper temperature after repairs, and is independent of building electric power supply. The door alarm is automatically turned on and off so it is operating only when the blood bank staff is absent. The power supply interruption alarm anticipates a temperature rise due to power failure by as much as an hour. The installation cost $160.