Sometimes wasting blood is the best choice, right?

Surgeon ordered 2 units packed cells to be infused stat. Gave 1 unit. Took hemocue. Hemocue was 10.6. Asked surgeon if he still wants the second unit. He said no. Returned unit to blood bank. Blood bank said unit was returned too late. Unit was discarded.

So the bad news is that a unit was wasted, but wasting blood is better than giving blood when not necessary, because there is always a tiny chance of virus-infected blood, right?

10.6 seems to still be low. What surgery was he doing. Was there still potential for blood loss? I can almost gurantee any surgeon I work with would have given it so it wasn't wasted.

10-minute D&C. He made the decision not to give the blood after the case

A healthy, young woman (which I assume to be the case with this patient) can compensate and recover quite readily with a Hgb of 10.6.

I can understand the surgeon's unwillingness to expose her to the risk of a second transfusion.

Do you always keep the blood in the room? We have a refrigerator in PACU that is dedicated for blood products, and we only grab them as needed. Blood bank does a pickup once a shift. That way, blood is available and close by, but not wasted if not needed.

10-minute D&C. He made the decision not to give the blood after the case

Makes sense. I just wasn't sure what surgery you were doing. Who asked for two units anyway? We have the same policy that if not given in a certain time the BB won't take it back. We usually only ask for 1 unit at a time unless an emmergency. We used to have a fridge in the OR so we could store blood but got rid of it a few years ago.

Sorry, just re-read your post. Strange he asked for both units, but I have found that alot of OB-GYNs get a little freaked when they see too much blood.

Also, Jolie what risk are you referring to? If TxC correctly and with no problems with the patient the risk is pretty minimal. I can't remember in 32 years a patient having any blood transfusion problems.

Edited Mar 23, 2009 by shodobe

Do you always keep the blood in the room? We have a refrigerator in PACU that is dedicated for blood products, and we only grab them as needed. Blood bank does a pickup once a shift. That way, blood is available and close by, but not wasted if not needed.

I've worked at hospitals that send the blood in a small cooler. I am assuming that some hospitals choose not to let staff refrigerate blood because it dangerously assumes that staff will always comply and keep the blood cold. There is no way of knowing if the staff thawed the blood before returning it to blood bank. When in doubt, throw it out. :wink2: