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Cell Saver Audit

Cell Saver Audit. Dr Richard Evans (CONS) Dr Vikram Halikar (SHO) Dr Kevin Chu (PRHO). Introduction. Fresenius CATS (Continuous AutoTransfusion System) Autologous blood transfusion Mechanism Citrate Collection & Filter Centrifuge & Wash Haematocrit 60% (depending on wash).

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Cell Saver Audit

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  1. Cell Saver Audit Dr Richard Evans (CONS) Dr Vikram Halikar (SHO) Dr Kevin Chu (PRHO)

  2. Introduction • Fresenius CATS (Continuous AutoTransfusion System) • Autologous blood transfusion • Mechanism • Citrate • Collection & Filter • Centrifuge & Wash • Haematocrit 60% (depending on wash)

  3. Why this Audit? • Usage & efficacy • Cost implications • Problems / Suggestions

  4. Why Use A Cell Saver • Loss of Transfusion Risk • Infection • Transfusion Error • Difficult Cross Match • Blood Shortage • Cost Benefits

  5. When not to use a Cell Saver • Tumour • Infection • Chemicals

  6. 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

  7. Cell Saver Audit Forms

  8. Operations • Vascular • Emergency AAA • Elective AAA • Urology • Cystectomy • Prostatectomy • Nephrectomy • Orthopaedic • Revision Hips / Occasional Total Hip Replacment • Spinal Fusions

  9. Usage - General

  10. Usage – AAA Repair

  11. Blood Returned & Units Transfused

  12. AAA Repair – Units Transfused

  13. 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

  14. 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

  15. 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

  16. 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

  17. Suggestions / Plans • 2nd Machine for Orthopaedics • Increase awareness • Routine collection for • All Hip operations • All Knee operations (not using tourniquet) • Femoral Nails • Expand staff training

  18. Re-Audit • This audit was first presented at the anaesthetic meeting on 5 September 2003 • Re-audit of use 6 months from then

  19. Thank YouAny Questions?

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