An analysis of surgical blood use in United States hospitals with application to the maximum surgical blood order schedule.

Excessive preoperative crossmatching can be limited with a maximum surgical blood order schedule (MSBOS) which is a list of the commonly performed elective surgical procedures performed in a hospital with the maximum number of units of blood which will be crossmatched preoperatively for each. The purpose of this study was to analyze the blood requirements of 535,031 surgical patients treated in 300 United States hospitals during 1974, and to suggest maximum preoperative blood orders including type and screen recommendations based on data derived from this large national patient sample. Such recommendations are offered for 63 common elective surgical procedures. Specific reference is made to blood utilization during hysterectomy, transurethral resection of the prostate, and cesarean section. A preoperative type and screen order is adequate for the vast majority of patients undergoing these latter procedures.