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Published byMyles Lawson Modified over 9 years ago
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Cell Saver Audit Dr Richard Evans (CONS) Dr Vikram Halikar (SHO) Dr Kevin Chu (PRHO)
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Introduction Fresenius CATS (Continuous AutoTransfusion System) Autologous blood transfusion Mechanism –Citrate –Collection & Filter –Centrifuge & Wash –Haematocrit 60% (depending on wash)
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Why this Audit? Usage & efficacy Cost implications Problems / Suggestions
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Why Use A Cell Saver Loss of Transfusion Risk –Infection –Transfusion Error –Difficult Cross Match Blood Shortage Cost Benefits
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When not to use a Cell Saver Tumour Infection Chemicals
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Data Collected Cell Saver audit forms –August 2002 – April 2003 inclusive –9 months –48 patients Theatre Ledger Emergency Operation Lists Diary of Bookings Blood bank records
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Cell Saver Audit Forms
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Operations Vascular –Emergency AAA –Elective AAA Urology –Cystectomy –Prostatectomy –Nephrectomy Orthopaedic –Revision Hips / Occasional Total Hip Replacment –Spinal Fusions
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Usage - General
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Usage – AAA Repair
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Blood Returned & Units Transfused
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AAA Repair – Units Transfused
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Cost Effectiveness Capital Cost –Cell Saver £21,000 (Now £14,000) –ODP Training £300 * 7 = £2,100 Running Costs (over 9 months) –48 cases * £90 disposables/case = £4,320
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Cost Effectiveness Total Salvaged 24,971ml (over 9 months) –Approx 250ml / unit i.e. 100 units –Cost / unit £120 –Total Saved £12,000 Predicted Saving –£12,000 - £4,320 = £7,680 (over 9 months) –£10,240 savings per year (at current usage) –£160 savings per case
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Problems / Missed Cases Availability –Of Cell Saver (double booking) –Of ODP trained in usage –Of ODP for usage in Emergency AAA Under-usage –Especially in orthopaedics –Relatively new technique –Lack of awareness: surgical & anaesthetic
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Conclusions Cell Saver is highly cost effective Second unit (in orthopaedics) would bring further cost benefit Expanding staff training would allow greater usage of the machine
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Suggestions / Plans 2 nd Machine for Orthopaedics Increase awareness Routine collection for –All Hip operations –All Knee operations (not using tourniquet) –Femoral Nails Expand staff training
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Re-Audit This audit was first presented at the anaesthetic meeting on 5 September 2003 Re-audit of use 6 months from then
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Thank You Any Questions?
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