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Overview :
Nuttall et al developed a standing blood order equation for
patients undergoing a total hip arthroplasty, but the concept should apply to
other surgical patients requiring blood. This is both is cost effective and
allows for better use of blood product inventory. The authors are from the Mayo
Clinic in Rochester, Minnesota.
standing blood order equation =
= (hemoglobin loss expected related to a surgical procedure
in g/dL)– ((preoperative hemoglobin in g/dL)– (minimum acceptable hemoglobin
for the patient))
where:
• Each unit of packed red blood cells effects a change in
hemoglobin of 1 g/dL.
• For patients
undergoing total hip arthroplasty, the expected hemoglobin loss was 3.7 +/- 1.7
g/dL for a primary arthroplasty and 4.8 +/- 2.4 g/dL for a revision
arthroplasty.
If the equation gives a value < 0.5, then a type and
screen is ordered.
If the equation gives a value >= 0.5, then a type and
cross is ordered for a number of units equal to the equation value rounded to
the nearest whole number.
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