TY - CPAPER AB - Introduction: Spinal correction surgery is associated with significant perioperative blood loss, often necessitating transfusion. Given the potential risks of blood transfusion we have introduced a pathway with the aim of reducing transfusion requirements. Method: A Spinal Surgery Care Pathway was developed. Its implementation involved a multi-disciplinary programme of several different interventions: nurse-led clinics allowing pre-operative haemoglobin levels to be optimised; intra operative cell-salvage, and a transfusion criteria awareness programme. The records of all paediatric patients undergoing spinal correction surgery between 2000 and 2010 were reviewed: haemoglobin levels; blood products administered; demographic and surgical details were recorded. Results: Data from 466 patients were analysed: 166 from before introduction of the pathway and 300 after. The proportion of patients undergoing transfusion dropped from 69.3% to 16.7% (p <0.0001), risk ratio 0.24 (95% CI 0.18 - 0.32). Where transfusion was required, the mean volume transfused fell from 8.2 to 4.5 units (p<0.001). Discussion: Implementation of this multifaceted pathway has significantly reduced blood product requirements. In addition to the reduction in morbidity this is likely to have implications upon length of stay and cost. We propose that other units undertaking such surgery consider the use of a similar pathway. AU - Lyle,S AU - Pinder,RJ AU - Mallinson,C PY - 2011/// TI - A multi-disciplinary approach to improving blood transfusion practice in paediatric scoliosis correction surgery ER -