General Hospital • Operating Theatre

Blood Loss Form

Dry Weight Reference Guide

45 x 45 Swabs
  • 1 Swab (Decto lap) = 40 GR
  • 5 Swabs = 200 GR
40 x 40 Swabs
  • 1 Swab = 20 GR
  • 5 Swabs = 100 GR
20 x 20 Swabs
  • 1 Swab = 10 GR
  • 5 Swabs = 50 GR
4 x 4 Swabs
  • 10 Swabs = 25 GR
1 GRAM (GR) = 1 ML Formula: Blood Weight - Dry Weight = Blood Loss (ML)
No. Size of Swabs Dry Weight
(Grams)		 Blood Weight
(Wet Wt - Grams)		 Swab Blood Loss
(ML)		 Amount in
Suction Bottle (ML)		 Cumulative
Blood Loss (ML)
1
2
3
4
5
6
7
8
9
10
11
12

Total Estimated
Blood Loss

ML

Circulating Nurse

Surgeon / Anesthetist