Early Hemoglobin Screening

Arthroplasty Patients Gross, Backstein, Safir 2009

Please collect a CBC and Group & Screen at the early pre-op visit.

The CBC will need to be reviewed by the surgeon within a day or two after the test.

The Group and Screen is the first step in the new two step process for all crossmatch testing.

Hgb <100

For hemoglobin results less then 100, an assessment for anemia will be required for planned surgery and may take considerable time before the date when OR time becomes available. Ambulatory Internal Medicine Clinic presently assesses with anemia for the pre-operative patients at MSH can be contacted through PAU.

100<Hgb<140

For hemoglobins more than 100 and less than 140 the patients would be requested to start oral iron therapy up to 6 weeks pre-operatively. Studies suggest half of these mildly anemic patients would be expected to respond to iron therapy before the PAU visit and have a decreased transfusion requirement.

Rx Ferrous Gluconate 300mg PO TID # 100 Rx2

For patients requesting Autologous blood donation please arrange for a PAU assessment at least 3 weeks prior to surgery.

contacts

Ron Lenz transfusion coordinator 2627 fax 8830

PAU 8824 fax 3230

AIM (C Boyce) 8563 fax 3168

Yours truly,

Ivor Fleming BSc MD CCFP FRCPC

Director of Clinical Anethesia Mount Sinai Hospital

Assistant Professor Anesthesia University of Toronto

416 586 5270

Fax 8664