We begin by checking the hemoglobin well before surgery. If you are a non-local patient, you must be sure there is no delay in getting your hemoglobin level to us; otherwise you prevent us from fully implementing our protocol. Too often patients and their primary care physician don’t send this information promptly. You are responsible for making sure this happens, we cannot chase down your physician.
As soon as we have the hemoglobin level, a strategy is implemented for maximizing the preoperative level. We also recommend eliminating all bleeding agents before surgery. During the operation numerous strategies are employed to reduce blood loss. Postoperatively we have a transfusion trigger of hg =7. Using this protocol our transfusion rate is less than 0.1% including bilateral surgeries done in the same week.