Abstract
In Ireland and the United Kingdom, there were 22 deaths as a direct result of blood transfusion during the period October 1996 to September 1998. Added to this mortality, there were 366 cases of complications directly related to blood transfusion.
With the introduction of a Haemovigilance Nurse, changing surgical personnel and an increased public awareness of the potential hazards of transfusion, we were anxious to review whether transfusion rates have changed in our Regional Orthopaedic Centre for the period January 1999 to July 2000
All patients undergoing primary or revision arthroplasty in our Regional Orthopaedic Unit during the study period were retrospectively reviewed.
459 primary or revision arthroplasties were performed in the study period. Prior to the introduction of a haemovigilance Nurse, from the period January 1999 to October 1999, transfusion rates for primary arthroplasties averaged 1.41 units/patient with 74% of patients being transfused. After the introduction of a haemovigilance Nurse, from November 1999 to July 2000, transfusion rates for primary arthroplasties averaged 0.51 units/patient, with 31% of patients being transfused.
Prior to the introduction of a haemovigilance Nurse revision arthroplasties averaged 2.5 units/patient, with 100% of patients being transfused. After the introduction of the haemovigilance Nurse transfusion averaged 1.2 units/patient, with 62% of patients being transfused.
There was a statistically significant difference between transfusion rates prior to the introduction of a Haemovigilance Nurse and new surgical personnel and the period after their introduction (p< 0.005).
In the current climate post the Finlay Tribunal and the resultant increased public awareness, transfusing a patient without justifiable cause is no longer acceptable.
Patients in this unit are now transfused according to clinical needs and accurate measurement of intra-operative and post-operative blood loss, compared to their calculated maximum allowed blood loss (MABL). The changing transfusion rates seen in our Unit correspond to the introduction of a Haemovigilance Nurse and a change in surgical personnel. Our new transfusion protocol is working well without compromising patient care.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at the Irish Orthopaedic Association, Secretariat, c/o Cappagh Orthopaedic Hospital, Finglas, Dublin
