Estimation of blood loss in a small community hospital.

THREE METHODS OF BLOOD LOSS ESTIMATION WHICH ARE SIMPLE, ACCURATE AND CHEAP ARE: (1) weighing of sponges; (2) estimation of blood volume with Evans blue dye and (3) measurement of central venous pressure (CVP).Weighing of sponges is a valuable operating-room procedure although it has certain defects some of which are described. The Evans dye method is used chiefly in preoperative assessment when hypovolemia is suspected but serial estimations are feasible and can be performed in 45 minutes. Measurement of CVP, however, is the best single criterion of effective blood volume in relation to cardiac functional capacity and is the best guide to blood and fluid requirements. A simple "homemade" device for making serial CVP determinations, incorporating a manometer and a zero level, is described.These methods of blood loss estimation do not supersede the traditional methods of the clinical assessment of the surgical patient, but are valuable adjuncts to such assessment.