Cost-effective yet quality health care delivery is one important objective worldwide now. Routine testing costs billion but without much impact. If a patient is not having pallore preop, planned for intermediate surgery; is it justified that only to know MABL and be prepared for unexpected hemorrhage, we should do preop Hb level? Hb level can even be done in point of care facility in such unexpected situations to decide transfusion...so, will it be a deficit if Hb not done in preop?
What you call intermediate surgeries encompass a vast majority of procedures, some of them being with a higher risk of unexpected hemorrhages. So, In my practice, pre-op Hb for similar operations is mandatory in order to avoid troubles when unexpected bleeding occurs. Moreover, we have in the algorityms and protocols of our health care system such a requirement for lab minimum parameters for different grade of surgeries. It should be fulfilled.
Agreed sir. Every institute in fact should have own data too with context to which surgery has how much blood loss (average / mean) including surgeon. As intraoperative blood loss can differ as per surgeon, surgery and technique. Accordingly maximum surgical blood order schedule should also be planned. However, all these exercises can be regarded as specific, not routine.
In my opinion, yes, it needs the preop. Hb test as the PT, INR, PTT tests, the number of platelets, the pantient's history about hematologic disordes, the discontinuance of the receiving any of anticoagulaunts, and mainly, the correct surgical intervention - technique.