Background: Blood transfusion is required in the management of life threatening orthopaedic trauma hemorrhages. There is great need to categorize trauma patients and match them appropriately with the need for blood transfusion. This will ensure appropriate use of blood and hence save on resources and patent safety.

Objective: To characterize orthopaedic trauma patients and the need for blood transfusion at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Methods: Descriptive cross-sectional study conducted at MTRH (March 2019- January 2020) on 132 orthopedic trauma patients who met inclusion criteria. Data (continuous and categorical) collected using interviewer administered structured questionnaire summarized, and presented in prose and table formats. Results: Males were 101 (76.5%), median age 36 (IQR: 28, 47) years; majority (42; 31.8) were of age group 21- 30 years old; referrals were- 95 (72%), 64 (48.5%) were unskilled workers and 64 (48.5%) had primary school level of education. Injured in road traffic accidents were 105 (79.5%) with 96 (72.8%) having sustained lower extremity fractures while 30 (22.7%) had multiple trauma. Mean Injury Severity Scores was 12.05 (SD: 6.21). Majority of patients had normal vital signs except for increased respiration rate (77; 58.3%). Most patients (94; 71.2%) had pre-transfusion haemoglobin level of 10g/dl or less, and were destined mainly for debridement (58; 43.9%) and Open Reduction and Internal fixation (ORIF) (61; 46.2%). The commonest blood group was O positive. The needs were Packed Red Blood Cells (PRBCs) transfusion in 127 (96.2%) and whole blood in 5 (3.8%).

Conclusion: Most patients were males, injured mostly in road traffic accidents with deranged vital signs and lower extremity fractures. Most were destined for debridement and ORIF, requiring mostly PRBCs.

Recommendations: Orthopaedic Surgeons should have high suspicion index in order to accurately categorize patients and match them with need for blood before surgery.