Do we need to cross-match blood in closed fractures of the shaft of the femur?
A total of 50 patients with isolated closed fractures of the shaft of the femur are presented. Eleven per cent of the blood specimens were merely grouped and saved on arrival, and the remaining 39 (78 per cent) were crossmatched between 2 and 6 units. Overall, 138 units of blood were crossmatched and only 16 units were used (11.5 per cent), none of them actually in the accident and emergency department. We can find no record of blood being given for resuscitation. The use of blood appeared to depend on the occurrence and timing of operation. We suggest that local policy for crossmatching blood for such patients takes into account the orthopaedic surgical plan, but that the routine instruction to cross-match blood on arrival be abandoned.
Cope
A R
AR
Accident and Emergency Department, St Batholomew's Hospital, London.
McGlone
R
R
Sloan
J P
JP
D000293:Adolescent; D000328:Adult; D001788:Blood Grouping and Crossmatching; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D005264:Femoral Fractures / Q000628:therapy*; D005596:Fractures, Closed / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged