Blood loss in orthopaedic injuries or procedures may be substantial, and more than 23 million units of blood components are transfused each year. The most frequent components used include whole blood, packed red blood cells, platelets, plasma derivatives, leukocytes, and clotting factors. This article will discuss blood classification systems, transfusion components, administration and potential complications of transfusion therapy, and nursing implications.
Orthopaedic injuries and procedures may lead to substantial blood loss. There is a potential to lose up to 805 cc for a cemented unilateral total knee repair and up to 2665 cc for a revision total hip arthroplasty. Intraoperative blood losses for a spinal fusion may be as much as 821 cc (Pellino et al., 1998).
Hemorrhage from a fractured humerus may cause a 500–1500 cc blood loss, an ankle fracture may cause 250–1000 cc loss, and a pelvic fracture may cause up to 6,000 cc blood loss (Strange & Kelly, 1993). More than 23 million units of blood components are transfused each year (American Association of Blood Banks [AABB], 1999). A review of blood replacement modalities and nursing implications will be discussed in this article.