Q: 88 year old female is admitted to ICU after fall and peritrochanteric fracture as a 'soft admission'! Patient has history of coronary artery disease. Orthopedic surgeon is planning to take her to OR. All labs are essentially stable. Hemoglobin is 11.4 g/dL. Which one precaution you will add?



Answer: Type and cross and pRBC ready for OR 

Peritrochanteric hip fractures are prone for peri-operative bleeding in elderly patients. Backup should be prepared if initial hemoglobin level is below 12 g/dL

References: 

1. Dillon MF, Collins D, Rice J, et al. Preoperative characteristics identify patients with hip fractures at risk of transfusion. Clin Orthop Relat Res 2005; 439:201. 

2. Adunsky A, Lichtenstein A, Mizrahi E, et al. Blood transfusion requirements in elderly hip fracture patients. Arch Gerontol Geriatr 2003; 36:75.