Guidance for the Provision of Intraoperative Cell Salvage

Guidance for the Provision of Intraoperative Cell Salvage is intended to inform health-care practitioners, health educators, health service managers and policy makers about Intraoperative Cell Salvage (ICS) use for patients undergoing surgery or invasive procedures, particularly those in which blood loss is anticipated. It is aimed at supporting hospitals to develop and implement an intraoperative cell salvage program.

The guidance is based on the UK cell salvage action group document Policy for the provision of Intraoperative Cell Salvage and has been reviewed by local clinicians to assess its applicability to the Australian health care setting.

Similar to the UK document, the guidance and accompanying resources in the appendixes, such as patient education materials, business case study and education competency workbook have been designed with the intention that they can easily be adapted to accommodate the local policies and practice of individual hospitals. They are available as generic baseline material to download, alter, and adapt as applicable to their local requirements.

The National Safety and Quality Health Service Standard 7: Blood and Blood Products require blood and blood product policies and procedures to be consistent with national evidence based guidelines for pre-transfusion practices, prescribing and clinical use of blood and blood products.

The ICS Guidance aims to improve clinical practice and patient outcomes through alignment with the Patient Blood Management (PBM) Guidelines.

Implementation of an intraoperative cell salvage program by health providers is not mandatory as a patient quality improvement measure.

The aim of the ICS guidance is to provide information that will allow clinicians to:

1. Appropriately identify suitable patients, undergoing elective and/or emergency surgical procedures, where ICS could be of benefit.

2. Safely utilise ICS in an effective manner.

The ICS guidance has been developed in accordance with the Patient Blood Management Guidelines and in line with National Safety and Quality in Health Service Standard 7: Blood and Blood Products. The ICS Guidance is part of the National Reference Set.

The ICS guidance was written in consultation with a clinical writing group comprising an anaesthetist, an orthopaedic surgeon and a perfusionist, and was reviewed by a clinical cross-jurisdictional group before being available for a six-week public consultation period.

Please feel free to adapt, alter and rebadge the Intraoperative Cell Salvage guidance and resource material as applicable to your local area.

ICS Guidance:

Additional resources:

Appendixes

Appendixes List

Appendix I - Business Case Guidance

Appendix IIa - Surgical procedures where Intraoperative Cell Salvage may present a significant benefit towards the management of perioperative blood loss

Appendix IIb - Surgical procedures – an Australian experience 

Appendix III - Audit Proforma

Appendix IV - Competency Assessment Workbook

Appendix V - Use of Intraoperative Cell Salvage in Obstetrics

Appendix VI - Use of Intraoperative Cell Salvage in Malignant Disease

Appendix VII - Cell Salvage Patient Information Leaflet

Appendix VIII - Manufacturers’ Guidelines

Appendix IX - Autologous Transfusion Label

Appendix X - Fault Log

Appendix XI - Patient material “About Patient Blood Management”

Acknowledgements:

The National Blood Authority extends their appreciation to the ICS clinical writing group, Mr Chris Morley, Dr Michelle Roets and Mr Daryl Teague for their involvement in the development of this guidance.