Introduction
Red blood cell (RBC) transfusions are common in clinical practice. In the UK, the NHS Blood and Transplant (NHSBT) health authority rely on a regular supply of voluntary contributions of whole-blood and apheresis donors to meet demand and have substantial direct and indirect costs to the health service and economy, respectively.1Furthermore there are risks associated with transfusion with an estimated risk of death of 1 in 117,000 components and serious harm of 1 in 21,000.2 Between 1999 and 2017 there has been a 34% reduction in RBC demand through the implementation of guidelines and Patient Blood Management initiatives.3 However, it is expected that the UK will need to increase the availability of blood components and utilize strategies to ensure these are used effectively, efficiently and safely to meet the growing demands of an ageing population.4
In a 2014 national survey, 27% of total RBC transfusions in England and North Wales were for surgical indications.5 Currently, there is limited literature on RBC transfusions in Otolaryngology otherwise known as Ear, Nose and Throat surgery (ENT). The available literature focuses on transfusions in Head and Neck cancer (HNC) surgery.6–8 We performed a 5-year retrospective analysis of RBC transfusions in a large tertiary ENT, Head and Neck centre. The aims were to evaluate ENT transfusion practice in a tertiary centre in accordance with current guidelines and literature, identify and analyse “outlier” transfusion practice and suggest how local ENT transfusion practice can be improved to maintain high standards of patient care and safety as well as ensure efficiency to meet the demands on blood components.