ABSTRACT
G eneral surgery is characterized by various procedures, m any o f w hich are infrequently associated w ith red cell transfusion . Because o f the potential, how ever, to require b lood transfusion in som e procedures, there is often a bias to ro u tinely request the availability o f crossm atched b lood or to request a type and screen p rio r to any procedure. For m any procedures in w hich a b lood transfusion is al m ost never required, there is little practical value in ob tain ing a b lood type or an tibody screen. For procedures in w hich there is a greater poten tia l for tran sfu sion (e.g., gastrectomy, low an terio r resection), a type and screen is appropriate . U nder these circum stances, if unexpected excessive bleeding is encountered , the transfusion o f uncrossed ABO identical and Rhesus com patible red cells is ac ceptable. It is im p o rtan t to develop a list o f procedures for w hich (a) a b lood specim en is n o t routinely requ ired (transfusion very rare), (b) those procedures for w hich a type and screen is appropria te (transfusion occasional), (c) and those procedures for w hich routinely crossm atching o f b lood is appropria te (e.g., liver resections, extensive u pper abdom inal resections for m alignancies and colorectal surgery). This list is often called a m ax im um blood-o rdering schedule (M BOSC hapter 9).
