Quantitative Blood Loss

[Rose_Queen, BSN, MSN, RN]

Hello all! My facility has started quantitative blood loss with lady partsl deliveries and is now looking to start the process with c-section patients. Our c-sections are done by our OR staff rather than our L&D staff, so of course the process is something brand new for us. Our OR specialty organization AORN does not have any guidance for this process. Would anyone be willing to share their QBL process for c-sections? Thank you!

[L&Dnurse13]

We take the amount of fluid in the suction canister at delivery of infant and subtract the end amount. We weigh all of the laps and towels used during the procedure subtracting the dry weight of the items and add that to the total. 

[klone, MSN, RN]

What a lot of places do is suction out the fluid and everything from the amniotomy, and then as soon as all the amniotic fluid is suctioned out and the infant is out, the canister is switched. Then, everything suctioned after infant birth is counted in the QBL (minus any irrigants that are introduced).

And weighing laps and pads as the previous poster mentioned. You should have a chart with all the dry weights, ideally posted next to the scale.

 

[Rose_Queen, BSN, MSN, RN]

Have either of you noted a lot of difference in dry weights of sponges? We tested weighing unused sponges. Unfortunately we're seeing a good bit of variation. Many are relatively close to the average but then we've had extremes on both sides as well.

[klone, MSN, RN]

What kind of extremes are you seeing?

[Rose_Queen, BSN, MSN, RN]

Differences of 15g on sponges, 110g difference for the disposable absorbent OR sheet that is on the bed. I haven't yet seen the calculation used to convert g to mL, so not sure if that's big enough to affect things.

[klone, MSN, RN]

g to ml is 1:1 so that’s a pretty significant discrepancy