Cell Saver Audit

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Cell Saver Audit

• Dr Richard Evans (CONS)
• Dr Vikram Halikar (SHO)
• Dr Kevin Chu (PRHO)

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Introduction

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

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Why this Audit?

• Usage efficacy
• Cost implications
• Problems / Suggestions

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Why Use A Cell Saver

• Loss of Transfusion Risk
• Infection
• Transfusion Error
• Difficult Cross Match
• Blood Shortage
• Cost Benefits

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When not to use a Cell Saver

• Tumour
• Infection
• Chemicals

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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

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Cell Saver Audit Forms
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Operations

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

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Usage - General
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Usage AAA Repair
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Blood Returned Units Transfused
12
AAA Repair Units Transfused
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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

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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

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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

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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

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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

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Re-Audit

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

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Thank YouAny Questions?