WELCOME YOU ALL FACULTY MEMBERS AND FRIENDS OF THE DEPTT. WONDERFUL PROCESS STARTED BY OUR DEPARTMENT. HAPPY NEW YEAR WITH SLOWLY ENTERING INTO 2013. ESTIMATION OF BLOOD LOSS. Prof: Anil Ohri DEPARTMENT OF ANAESTHESIA INDIRA GANDHI MEDICAL COLLEGE, SHIMLA-171001. INTRODUCTION.
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HAPPY NEW YEAR WITH SLOWLY ENTERING INTO 2013
Prof: Anil Ohri
DEPARTMENT OF ANAESTHESIA
INDIRA GANDHI MEDICAL COLLEGE,
WHY ESTIMATION OF BLOOD LOSS ….?
End By Seeing Blood-Suction Container and Surgical sponges. Underestimated.
*Many Techniques Devised –Estimate Accurately, Includes –Mathematical Model, Photometric Method,Cell Counts on blood loss.
Methods Time consuming, Impractical,& Expensive.
1.Pulmonary Gas Exchange
3.Blood Oxygen Contents
5. Oxygen consumption
Oxygen Extraction Ratio=Art O2 -Mix VO2/A O2
1.Measurement of HB%
2. Measurement Of PCV &or HCT%
5. Calorimetric method
1. Measurement of WONDERFUL PROCESS STARTED BY OUR DEPARTMENTHb%
7-10 gm%. Simple can give us rough estimates pre & or postoperatively. Mortality related with Hb<6gm%-mortality 61.5%;7.1% if 10 gm% or more.by CARSEN JL etal,1988 reported in severity of Anaemia &operative mortality morbidity,TEXAS.
Allowable Blood Loss (ABL)*
EBV x (Hi - Hf)Hi
= ABL Blood volume
Hi = initial Hct Blood volume
Normal Hct Values***
37-47% Hf = final lowest acceptable Hct
Estimated Blood Volume (EBV)
A) WEIGHING OF PATIENT: Operation Table Available To Measure Pre and post Surgery Weight Accuracy +- 10 G.
Inaccurate. Good Check On other Methods.
B) WEIGHING SWABS: Simple & Commonly Used.
Bloss Measured in GAIN Of Weight Of Swab &Towels Together with Contents of Bottle1ml of Blood=1Gm of swab ;Underestimation of 25%. Source of Error SP GR RBC-1.0293 ;Sp Gr Plasma-1.0270,
C)Modified BY Bonica & Lyter 1951 Using saline for comparison
200(Dilution Factor)XPatients Hb%
(ESTIMATION OF BLOOD LOSS DURING SURGERY J. A. Thornton Ann R Coll Surg Engl. 1963 )
8.VISUAL COMPARATIVE COLORIMETRY:
estimation of blood loss in the third stage of labour:
a cluster randomised trial (This protocol follows the recommendations for reporting randomised controlled trials
described withinEUPHRATES-Protocol-C-RCT-11-2005-approved by Collaborators meeting
REF.BLOOD LOSS: CLINICAL TECHNIQUES FOR ONGOING QUANTITATIVE MEASUREMENT(Audrey Lyndon, PhD, CNS, RNC, Department of Family Health Care Nursing, University of California, San Francisco; Suellen Miller, PhD, CNM, MHA, Department of Obstetrics;Gynecology and Reproductive Sciences, University of California, San Francisco; Valerie Huwe;RN, BSN, El Camino Hospital; Mark Rosen, MD, Department of Anesthesia, University of California, San Francisco; David Lagrew, MD, Saddleback Memorial Medical Center; Patricia
Dailey, MD; Anesthesiology, Mills Peninsula Health Services; Elliott Main, MD, Department of OB/GYN, California Pacific Medical Center, Sutter Health)