Blood & Surgery
This booklet is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.
Golden Rule for X match: when a blood sample is typed & held in the blood bank (Compat) X matched blood, if requested, can be available in 30-40 minutes. This is adequately fast in almost all circumstances where blood is necessary in Theatre.
Do not X match unnecessarily – it is expensive & wastes laboratory time. Check before surgery that a taken Compat sample IS in the lab for possible X match. If it is not, send another & check they have it.
If the Hb exceeds 10 for most operations a Compat is enough. X match for ovarian malignancy, large fibroids, immobile masses where dissection is expected, evacuation of molar pregnancies, abdominal pregnancies. An FBC & U&E is expected for almost all surgery.
Where massive transfusion is expected or DIC is established ask for fresh frozen plasma(FFP). Consider platelets. In these circumstances X match early not late.
HIV tests should be offered & performed whenever patients are seen. Research has shown that opportunities to test are missed.