Maximum Surgical Blood Ordering Schedule(MSBOS) in Elective Surgery Cases: An Original Study in Firoozgar Hospital

Blood over ordering is a common practice in elective surgeries which can be corrected by a simple mean of changing the blood ordering pattern. Nowadays, the use of Maximum Surgical Blood Ordering Schedule (MSBOS) is the accepted standard of practice for hospital blood banking almost throughout the world. Therefore, a retrospective study was carried out for the first time in Firoozgar Hospital for a period of one year (2002) to study the ordering strategies in this hospital. Blood ordering and transfusion practices were evaluated in 364 elective surgical patients including 6 common major procedures: cesarean section (C/S), thyroidectomy, total hysterectomy, laminectomy, cholecystectomy and modified radical mastectomy (MRM) with the help of different indices such as cross-match to transfusion ratio (C/T ratio), transfusion probability (T%) and transfusion index (TI). Transfusion guidelines for these 6 procedures were proposed. Due to existence of a high total C/T ratio (21.5) (accepted standard value=2.5 times) and very low utilisation percenage of cross-matched units (only 4.7%), it is concluded that change of blood ordering pattern in this hospital is necessary. Also, type and screen (T&S) procedure can be introduced in these 6 procedures as a guideline for preoperative blood ordering.