1. Intraoperative Cell Salvage
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Intraoperative Cell Salvage
Basic Blood Facts
Blood Conservation
Haemovigilance
Principles of Intraoperative Cell Salvage
Indications and Contraindications
Practicalities – Blood Collection
Practicalities – Blood Processing
Practicalities – Blood Reinfusion
Information and Best Practice
Unloading and Discarding

2. UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Learning Outcomes
To identify the equipment used for reinfusion and describe the function of each component
To describe the composition of the final product for reinfusion
To identify the conditions for reinfusion

3. Blood Reinfusion ICS end product RBCs in IV normal saline (0.9% NaCl)
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Blood Reinfusion
ICS end product
RBCs in IV normal saline (0.9% NaCl)
Haematocrit ~ 50-70%

4. Blood Reinfusion ICS end product
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Blood Reinfusion
ICS end product
The decision to use blood that is potentially contaminated with bacteria, amniotic fluid or malignant cells should be made by the clinicians caring for the patients, taking into account the latest evidence and considering the risks and benefits for the individual patient.

5. Blood Reinfusion ICS end product
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Blood Reinfusion
ICS end product
In cases of massive haemorrhage, it is likely that the patient will require allogeneic (donor) blood components e.g. Platelets, Fresh Frozen Plasma, Cryoprecipitate and RBCs

6. Blood Reinfusion Prescribing ICS Blood
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Blood Reinfusion
Prescribing ICS Blood
The reinfusion of ICS blood should be prescribed by the responsible clinician on the documentation approved within your hospital.

7. Blood Reinfusion Filters Obstetrics & malignancy
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Blood Reinfusion
Filters
Type of filter
Medium
Removes
Standard blood administration set
µm screen
Blood component and non-blood component particulate matter.
Microaggregate blood filter
40µm screen
Blood component microaggregates and non-blood component particulate matter.
Lipid depleting microaggregate filter
Microaggregates, lipids, C3a, some leucocytes.
Leucodepletion filter
Affinity filter
Leucocytes, lipids, microaggregates, some bacteria
Obstetrics & malignancy

8. Blood Reinfusion Reinfusion “Storage” Time limits
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Blood Reinfusion
Reinfusion
“Storage”
Time limits
Reinfusion can occur:
While reinfusion bag is still attached to ICS disposable
The reinfusion line from the processing set must remain open for this set up.
Once it has been disconnected
The reinfusion bag should not be disconnected while the machine is processing.

9. Blood Reinfusion Administration of ICS blood Pre-transfusion checks
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Blood Reinfusion
Administration of ICS blood
Pre-transfusion checks
Standard blood transfusion practice
Baseline observations
Patient ID
Expiry time / damage or abnormality of blood
Administration of blood
Appropriate filter
Observations
Documentation

10. Blood Reinfusion Transfusion reactions
UK CELL SALVAGE ACTION GROUP
EDUCATION WORKBOOK
Blood Reinfusion
Transfusion reactions
If a transfusion reaction is suspected, STOP the reinfusion and see immediate advice from the lead surgeon and/or anaesthetist.
Incident reporting (according to local policy)