1 st opportunity (at referral or listing)
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Pathway for patients referred for consideration of major elective orthopaedic surgery (hip / knee replacement) 1 st opportun ity (at referral or listing) Review Visit 1 Review Visit 2 Check FBC and review results: If Hb: <120g/L (F) or <130g/L (M) Arrange anaemia investigations:(sequential or batch depending on local arrangements ) FBC, retics, UEC, LFT, B12, folate, ferritin, transferrin saturation, CRP Review Anaemia Investigations Apply anaemia management algorithm Further investigation, referral, optimisation including investigation of underlying cause eg: gastroenterology referral – individualised care Non-iron deficiency anaemia – manage accordingly ** Iron deficiency anaemia: absolute (ferritin <30) or functional (ferritin 30-100 and transferrin saturation<20%) < 8 weeks before planned surgery date eg: clinically urgent** ≥ 8 weeks before planned surgery date eg: clinically NON-urgent Day case admission for IV iron – Recheck Hb after 2 weeks Trial of oral iron Recheck Hb 4 weeks Anaemia persists despite oral iron Hb normalised with oral iron: continue oral iron until surgery Surgery 2-4 weeks depending on response to iv iron and urgency of surgery (may need repeat dose)** GP version 2014 **If anaemia persists or surgery is urgent proceed on case by case basis following discussion with surgeon / anaesthetist
description
Pathway for patients referred for consideration of major elective orthopaedic surgery (hip / knee replacement). 1 st opportunity (at referral or listing). Check FBC and review results: If Hb:
Transcript of 1 st opportunity (at referral or listing)
Pathway for patients referred for consideration of major elective orthopaedic surgery (hip / knee replacement)
1st opportunity (at referral or listing)
Review Visit 1
Review Visit 2
Check FBC and review results:If
Hb: <120g/L (F) or <130g/L (M)
Arrange anaemia investigations:(sequential or batch depending on local arrangements )FBC, retics, UEC, LFT, B12, folate, ferritin, transferrin saturation, CRP
Review Anaemia InvestigationsApply anaemia management algorithm
Further investigation, referral, optimisation including investigation of underlying cause eg: gastroenterology referral – individualised care
Non-iron deficiency anaemia – manage
accordingly **
Iron deficiency anaemia: absolute (ferritin <30) or
functional (ferritin 30-100 and transferrin saturation<20%)
< 8 weeks before planned surgery date
eg: clinically urgent**
≥ 8 weeks before planned surgery date
eg: clinically NON-urgent
Day case admission for IV iron – Recheck Hb after 2
weeks
Trial of oral ironRecheck Hb 4 weeks
Anaemia persists despite oral iron
Hb normalised with oral iron: continue oral iron until
surgery
Surgery 2-4 weeks depending on response to iv iron and urgency of surgery (may need repeat dose)**
GP version 2014
**If anaemia persists or surgery is urgent proceed on case by
case basis following discussion with surgeon / anaesthetist
