All patients receiving transfusion must wear a patient ID wristband. Minimum identifiers:
Last name
First name
Date of birth
Unique patient identification number
Clear indication to transfused, based on assessment of the individual patient and their specific clinical situation.
Clear documentation of indication and symptoms
Clear authorisation for transfusion, including component to be transfused, date of transfusion, volume / number of units to be transfused, the transfusion rate and blood product specifications.
Patients must provide informed consent for transfusion, where possible.
Pre-transfusion samples must be positively identified. Sample collection and labelling must be done as one continuous uninterrupted event by a trained, competent member of staff.
Clear and unambiguous communication of the above between clinical and laboratory staff.
Blood Product Administration
Blood components must only be administered by trained, competent, registered healthcare practitioners.
Transfusion should only take place if adequate facilities for monitoring throughout the transfusion are available.
Patients must be positively identified before transfusion.
Identifiers on the patient’s ID band must matched the laboratory-generated label attached to the component.
The donation number, blood group and expiry date on the blood component pack must match the information on the laboratory-generated label.
Additional clinical requirements for blood products (e.g. irradiated blood) must be checked.
4ml/kg of RBCs will raise the Hb by 1g/dL (1 unit = 1g/dL is only true for a 70-80kg patient).
Monitoring should include the pulse rate, blood pressure, temperature and respiratory rate of the patient. Minimum monitoring includes:
Pre-transfusion
15 minutes after the start of each component unit
Post-transfusion, not more than 60 minutes after the completion of transfusion
Regular visual observation throughout the transfusion
The time each unit was completed and post-transfusion symptom resolution should be documented.
Return of Unused Blood
RBCs: transfuse within 4h of removal from controlled temperature.
Up to 30 min outside controlled temperature storage: can return directly to issue location. No restriction on how many times this can happen.
30-60 min: return to a separate storage refrigerator. Store for at least 6h (to allow blood to return to 2-6°C) before re-issue. Maximum three times out of storage for 30-60min.
>60 min: dispose of bag.
FFP: use ASAP on thawing, and transfuse within 4h of issue. If delay unavoidable:
Can be return to issuing location if out of controlled storage for <30min on one occasion.
>30min out of storage: only for re-issue if transfusion can be completed within 4h of the original issue time.
4h at 20-24°C (8h for SD-FFP)
24h at 2-6°C
120h at 2-6°C, only for use in major haemorrhage where delays in FFP are unacceptable.
Cryoprecipitate: use ASAP on thawing and transfuse within 4h of issue
Cannot be refrigerated.
Any returned units can only be re-issued if transfusion can be completed within 4h of original issue.
Platelets
Each interruption to agitation should be no longer than 8hrs.
Total interruption no more than 24hrs.
Normally stored at 20-24°C with constant gentle agitation.
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