Do children need routine preoperative blood tests and blood cross matching in orthopaedic practice?

A review of 315 children admitted for elective orthopaedic surgery on 346 occasions showed that 88.7% had a full blood count and 8.1% had serum urea and electrolyte estimations performed preoperatively. Two abnormal haemoglobin concentrations were found. One was known beforehand and the other clinically suspected. No other haematological or urea and electrolyte abnormality was found. On 82 occasions (23.7%) blood was cross matched. Blood was transfused on 15 occasions (18.3%) using 23% of cross matched blood. Routine preoperative full blood count, serum urea and electrolyte estimations are not indicated in healthy children. In our experience, only children who may need blood transfused postoperatively need a preoperative haemoglobin concentration estimation as a baseline. These are patients undergoing major spinal, pelvic girdle and upper femoral surgery.