HB Blood Component Transfusion Mod1 Rev01

BLOOD
COMPONENT TRANSFUSION

Module 1:

Decision to Transfuse

1 www.healthierbusinessltd.co.uk

INTRODUCTION
The safe and appropriate use of donor blood and alternatives to donor blood are important public health
and clinical governance issues. The transfusion of blood and blood products are an important, and in some
instances life- saving and part of the treatment of my patients. The aim of the package is to assist all
healthcare workers to provide consistently safe and effective high standards of clinical practice and avoid
error which unfortunately can potentially lead to death or causing long term damage to the
recipient/patient. Such potentially fatal errors are almost completely preventable through consistent good
practice However audits of practice in transfusion have shown that simple preventative measures such as
the patient having a correct wristband or observations being taken in the first 30 minutes of transfusion
can be overlooked (Taylor 2005).

As the learner, you will require to undertake four separate modules, followed by a short question and
answer tests after each module before you can achieve your certificate. The four modules you are required
to complete are as follows:

Decision to Transfuse
Blood Sampling
Collection of Blood Components from Storage and Delivery to the Clinical Area
Administration of Blood Components.

This course and its contents has been developed to ensure that all healthcare workers can participate
safely in the transfusion process, in line with the Health Service Circular, Better Blood Transfusion - Safe
and Appropriate Use of Blood (2007), UK Blood Services, The Serious Hazards of Transfusion (SHOT)
scheme, the National Blood Transfusion Committee (NBTC), England and the respective committees in
Northern Ireland, Scotland, Wales and Republic of Ireland.

It is useful for staff new to blood transfusion nursing, current health workers as a refresher in their learning
and non-medical prescribers for blood components. It will explore the alternatives to blood transfusions,
blood sampling and knowing which equipment and materials that are required to obtain serology, the
collection, storage and delivery of components and legislation that should be adhered to meet the criteria
and expectations of clinical standards of care and to gain an understanding on the importance of consent,
indication of blood transfusion and continuous patient monitoring during the procedure.

MODULE 1: DECISION TO TRANFUSE

Learning Objectives

By the end of the course you will have achieved the following:

understand transfusion issues
Be able to identify the blood components available and have an understanding of the indications of their
use
Be aware of the benefits, risks and anticipated outcomes to transfuse patients
Ensuring your patient is aware that they may be having a blood transfusion and that they understand
why they will be having it, what this will involve and potential risks.
Understand the importance of ensuring your patient has expressed informed consent (except in
exceptional circumstances) in advance.
Be able to access your local policies
Know the processes to prescribe/authorise blood components.

THE DECISION TO TRANSFUSE

To determine if it is an appropriate course of action for a particular patient, there are a number of different
factors to consider. As with any medical procedure, a blood transfusion can bring with it a range of risks
and potential benefits. Transfusion should only be used when the benefits outweigh the risks and there are
no appropriate alternatives.

Blood transfusion can be life-saving and is a key component of many modern surgical and medical
interventions and should only be considered where there is sufficient evidence through clinical assessment
and laboratory tests to suggest that the patients condition is likely to deteriorate or potentially life-
threatening. Avoiding unnecessary and inappropriate transfusions is both good for patients and essential
to ensure blood supplies meet the increasing demands of an ageing population. Sound clinical judgement
based on assessment should be the most important factor in the decision to transfuse and evidence-based
guidelines should be followed where available.

It is absolutely essential to consider each potential transfusion case on its own merit. If blood or
component transfusion is necessary, it must meet the following four criteria:

The right blood type, or component for the situation
The right patient - always ensure that you have carefully checked the patients identity
The right time to be offering the transfusion
The right place to be offering the transfusion

Every in-patient who is having blood sampled for a transfusion must be wearing a correct identity
wristband. If you are caring for a patient who is going to have a pre-transfusion blood sample taken and
who does not have a wristband, you must identify the patient using two separate identifiers (e.g. full name
and date of birth, or full address) and provide the patient with an identification bracelet containing as a
minimum their surname, first name, hospital number/C.H.I. number, gender and date of birth.

It is legal and ethical practice to ensure that valid consent is obtained from a patient before any
medical/surgical intervention, including the administration of blood products.

In 2011, the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) published a report
Patient Consent for Blood Transfusion which includes the following recommendations:

Valid consent for blood transfusion should be obtained and documented in the patient's clinical
record by the healthcare professional.
There should be a modified form of consent for long term multi-transfused patients, details of which
should be explicit in an organisation's consent policy.
Patients who have received a blood transfusion and who were not able to give valid consent prior to
the transfusion should be provided with information retrospectively. (JPAC, 2016)

WHO CAN PRESCRIBE A TRANSFUSION?

There is no specific staff group who can authorise transfusions or request collection from the laboratory, as
blood components are not licensed. The task is frequently delegated by the Doctor or specialist who is
known as the independent prescriber. Depending on your role and function you may be a supplementary
prescriber and asked to request the blood component after the independent prescriber has assessed the
patient.

In some cases, non-medical staff can also request blood components if they are appropriately trained and
deemed competent; documentation will validate if this is the case. You must check with the hospital or
medical centre where you work and establish your understanding of their processes and procedures. If you
are unsure of the process you must seek guidance from your line manager or shift supervisor.

DOCUMENTATION

Each stage of the process has strict documentation guidelines making sure the process is safe for the
patient and that each component can be tracked, including who was involved in the transfusion process.
Pre-transfusion requirements
The reasons including laboratory and/or clinical data
Any risks, benefits or possible alternatives, this must include patient consent
What is being transfused and the dosage
Any other special requests or requirements

TRANSFUSION PROCESS

Who was involved including all clinical and nursing staff starting and completing the process
Date and time the transfusion started and finished
The donation number
Observation records
Post-transfusion
Any outcomes and their subsequent management
Success of the transfusion

THE RIGHT BLOOD TYPE OR COMPONENT

Blood is the red fluid that circulates in our blood vessels veins and arteries. It acts as the bodys transport
system to distribute and circulate oxygen and de-oxygenated blood to vital organs and also plays a major
role in the bodys defence against infection. There is no substitute to blood and can only be replaced by
donations from other individuals. Its consists of different component each serving its own purpose and can
be separated to allow patients to be administered the specific component that is clinically indicated to
treat them.

Most common transfused blood components include;

Red blood cells

Red blood cells contain haemoglobin, which distributes oxygen to body tissues, and carries waste carbon
dioxide back to the lungs. Red blood cells are used to treat all kinds of anaemia (where people have low
haemoglobin levels) including:

as a result of rheumatoid arthritis or cancer
when red cells break down in new born babies
sickle cell diseases
Red blood cell transfusions are also used to treat severe blood loss due to traumatic injuries, during
surgery or in childbirth.

White blood cells

White blood cells (also known as leucocytes) are an important component of your blood system. Although
your white blood cells account for only about 1% of your blood, their impact is significant. White blood
cells are essential for good health and protection against illness and disease. They are vital in the fight
against infection and are part of the body's defence system. White cell transfusions may be given to
patients suffering from life-threatening infections whose normal defence mechanisms don't seem to be
responding to antibiotics.

Platelets

Platelets are crucial in helping blood to clot: they do this by clumping together to stop bleeding after an
injury. They can be used:

to treat cases of bone marrow failure
following a transplant or chemotherapy treatments
to treat leukaemia
Plasma

Yellow fluid that transports blood cells and platelets around the body and contains a number of
substances, including proteins which are often important ingredients in medical procedures.

Plasma includes:

albumin - a protein useful for treating kidney and liver disease
clotting factors - used to treat types of haemophilia and diseases where blood doesnt clot properly
immunoglobulins - these antibodies help protect against infections

There are also specific considerations for each of the individual blood components that may be transfused.

Red blood cells
Use restrictive red blood cell transfusion for patients who do not have major haemorrhage, acute
coronary syndrome or need regular blood transfusions due to anaemia. In these cases, consider a
threshold of 70g/litre with a haemoglobin concentration of 70-90g/litre after transfusion.
For patients with acute coronary syndrome then you should consider a threshold of 80g/litre with a
haemoglobin concentration target of 80-100g after transfusion.
If your patient has chronic anaemia and requires regular transfusions, you should set your own
concentration targets based on their individual case. Consider single-unit red blood cell transfusions
(or equivalent volume to reflect the patients body weight) in cases where the patient is not bleeding.
After any transfusion, you should recheck the haemoglobin levels and assess whether further
transfusions may be required.

Platelets
Patients with thrombocytopenia who are bleeding significantly should be offered a platelet
transfusion if their platelet count has fallen below 30x10^9 per litre. If the patient has severe
bleeding, or bleeding from critical sites such as the central nervous system or the eyes, you should
consider a platelet threshold of up to 100x10^9 per litre.
Patients who are neither bleeding nor involved in invasive procedures or surgery may be offered
prophylactic platelet transfusions if they have a platelet count below 10x10^9 per litre and do not
have any of the following conditions:

! Chronic bone marrow failure
! Heparin-induced thrombocytopenia
! Autoimmune thrombocytopenia
! Thrombotic thrombocytopenic purpura

If patients are having surgery or invasive procedures, you can consider prophylactic platelet transfusions
to aim to raise the count above 50x10^9 per litre.
If patients have a high risk of bleeding, you may wish to consider higher thresholds such as 5x10^9/litre
as long as you consider: the cause of the thrombocytopenia, the specific procedure the patient is having,
whether the patients platelet count is decreasing, whether there are any coexisting causes of abnormal
haemostasis and the cause of the thrombocytopenia in the first place.
If surgery is being performed in critical sites including the central nervous system or the posterior
segment of the eyes, then you may wish to consider raising the platelet count above 100x10^9/litre.

You should NOT consider platelet transfusions if the patient has any of the following:
Chronic bone marrow failure
Heparin induced thrombocytopenia
Autoimmune thrombocytopenia
Thrombotic thrombocytopenic purpura

You should also refrain from offering platelet transfusions to patients having procedures with low risk of
bleeding, such as adults having central venous cannulation, or any patients who are having bone marrow
aspiration and trephine biopsy.
Do not routinely offer more than a single dose of platelets. Consider more than a single dose only for
patients with severe thrombocytopenia and bleeding in a critical site such as the central nervous system or
the eyes. Reassess the patients clinical condition after any transfusion of platelets, and only ever give
further doses if necessary.

Cryoprecipitate (prepared from plasma, delivered as a frozen blood product)

If patients are without significant haemorrhage, consider cryoprecipitate transfusion if they have
clinically significant bleeding and their fibrinogen level is below 1.5g per litre.

Do not offer cryoprecipitate transfusions in an effort to correct fibrinogen levels in patients who are not
bleeding and are not having surgery or clinically invasive procedures with a risk of clinically significant
bleeding.

Prophylactic cryoprecipitate transfusions may be appropriate for patients who have a fibrinogen level
below 1.0g per litre, are having surgery or an invasive procedure with a clinically significant risk of
bleeding.
An adult dose for cryoprecipitate transfusions is 2 pools. For children, this should be 5-10ml per kg up to
a maximum of 2 pools.

After the transfusion, monitor and reassess the patients clinical condition. Always retest the fibrinogen
level before deciding whether a further dose is needed.
Prothrombin complex concentrate

This transfusion should be offered immediately for an emergency situation where you need to reverse the
effects of warfarin anticoagulation. This can be used for patients who are bleeding severely of who have
head injury with suspected intracerebral haemorrhage.
Detailed guidance on what to do for patients who have a stroke and a primary intracerebral haemorrhage
are available from NICE: https://www.nice.org.uk/guidance/cg68/chapter/1-Guidance , you should ensure
you are familiar with this should your role require it.

You should also consider immediate prophylactic Prothrombin complex concentrate transfusion for
patients who are having emergency surgery and you need to reverse warfarin anticoagulation, but only
after carefully considering the bleeding risk and the level of anticoagulation in each case.

INR is the abbreviation used to describe the Internal Normalised Ratio. This is what must be monitored to
confirm that you have successfully reversed the warfarin anticoagulation. You must always check this
before considering further prothrombin complex concentration transfusions.

Fresh frozen plasma

Should only be considered when patients have clinically significant bleeding but without major
haemorrhage if they have abnormal coagulation test results.
Do not offer fresh frozen plasma transfusions to try and remedy abnormal coagulation if the patient is not
bleeding (unless they are having surgery or clinical procedures with a clinically significant risk of bleeding),
or to patients who need a reversal of a vitamin K antagonist.

Prophylactic fresh frozen plasma can be considered for patients who have abnormal coagulation and are
having surgery or invasive procedures that have a clinically significant risk of bleeding. After any dose,
repeat the coagulation tests and reassess the patients clinical condition before determining a further
transfusion. Monitor this to ensure they are receiving an adequate dose.

BLOOD COMPONENT TRANSFUSION RISKS

Any medical procedure is not without its share of risks, blood and component transfusions are no different.
Steps can be taken to mitigate most risks but it is important to understand what they are to ensure that
you are practicing in a safe way.

Allergic reactions are the most commonly reported adverse event during or following blood transfusion
where the immune system reacts to proteins or other chemicals within the donated blood. The symptoms
of these reactions are usually mild and will appear either during or shortly after the transfusion.

Symptoms to watch for include itchy or red inflamed area on, oedema or swelling to extremities including
the hands and feet, dizziness, or headaches. Less common symptoms may appear such as pyrexia (high
temperature) or shivering, shortness of breath or swelling to the lips and eyes. Most cases of allergic
reaction are not very serious and can be successfully managed by slowing or stopping the transfusion, and
by treating the symptoms with medication such as antihistamines or possibly paracetamol.

Rare but more serious condition can occur known as Anaphylaxis a severe, potentially life-threatening
allergic reaction that can develop rapidly.
It is also known as anaphylactic shock and must be treated immediately, usually with an injection of
adrenaline.

Signs of anaphylaxis include:

itchy skin or a raised, red skin rash
swollen eyes, lips, hands and feet
feeling lightheaded or faint
swelling of the mouth, throat or tongue, which can cause breathing and swallowing difficulties
wheezing
abdominal pain, nausea and vomiting
collapse and unconsciousness

In some situations, it is possible for a transfusion to result in too much blood entering the body in a short
time, this is known as fluid overload and is quite rare. It is most common amongst people with low body
weight, the elderly and frail patients. The effect of the excess fluid is that the heart is unable to pump
enough blood around the body, potentially causing heart failure. The lungs can also become filled with
fluid causing shortness of breath. Fluid overload is a greater risk for older patients, and those with serious
health conditions such as heart disease. Medicine needs to be given to people with fluid overload, usually a
diuretic, which will help the body reduce excess fluid. In patients who have experienced fluid overload, it is
important to reduce the speed of future transfusions.

Although very rare, the risk of lung injury cannot be overlooked because it is so serious. Transfusion-
related acute lung injury (TRALI) occurs most often with platelets and plasma, rather than red cells. TRALI
occurs when the patients lungs become very inflamed, normally within 6 hours of the transfusion, and the
high inflammation causes the lungs to become starved of oxygen. Experts currently believe that this
inflammation is caused by an unusual immune response to the transfusion. Treatment normally requires a
ventilator to provide the body with oxygen until the inflammation subsides again.

Haemolytic transfusion reaction (HTR) is another recognised complication that can occur during or
following a transfusion and is caused by the bodys immune system reacts to the donated blood and
rejecting by attacking the cells. This can happen during or soon after a transfusion, or it may take a few
days or even a week for the reaction to take place.

There are also potential risks if the blood to be transfused has been contaminated. Every effort will have
been made to ensure that the donated blood is kept sterile (germ-free) but in very rare circumstances
bacteria can develop in the blood before it is transfused. This can happen to any of the components but
platelets are the most vulnerable to this form of contamination. The reason for this is because the platelets
must be stored at room temperature rather than refrigerated. Symptoms of blood poisoning, which is
known as sepsis, may result from receiving a transfusion of contaminated blood. Things to watch out for
include a high temperature, chills, rapid breathing, being confused, cold and clammy skin, or a rise in
heartbeat. Normal treatment would be antibiotic injections.

Rarer still than bacterial infection is the risk of viral contamination in the blood such as blood borne
viruses. The reason this is so rare is because of the stringent screening and testing procedures in place. The
sort of viruses which can be transferred by contaminated blood include hepatitis B, hepatitis C and HIV, but
there has not been a recorded case of a patient developing a viral infection from a blood transfusion since
2005.

BENEFITS OF TRANSFUSION

These risks need to be balanced against the many potential benefits of offering a blood transfusion. The
main benefits of a blood transfusion are saving lives and limiting the complications of major blood loss.
There are three main scenarios where a patient may require a blood component transfusion.

During childbirth, surgery or major accident
Treating anaemia
Treatment of inherited disorders of the blood such as sickle cell anaemia or thalassaemia

The medical benefits of blood transfusions are more complex and concentrate on components of blood
and using donated blood for more than one patient.

It is possible to treat a patient with the specific blood component which they are lacking, rather than
transfusing complete blood. This not only makes the system much more efficient but also helps to
minimise the risk of adverse reactions to the transfusion as you are introducing less into the patients body.
By carefully separating all the blood components out and handling them properly, it becomes possible to
treat multiple patients from each blood donation.
It is also possible to use certain blood components in other therapeutic support. For example, patients with
Haemophilia A can be treated with Factor VIII which can be made from plasma which is not directly needed
for transfusion purposes.

Each blood component has specific storage requirements, and shelf-life. By separating them all out and
handling them correctly it helps to improve the quality of each component to be used.

ANTICIPATED OUTCOMES OF TRANSFUSION

Different types of blood component transfusions will bring different outcomes for the patient. Let us take a
moment to consider the anticipated beneficial outcomes of each type of transfusion:

Blood or component type Key uses

Red blood cells or whole blood Trauma
Surgery
Anaemia
Any blood loss
Blood disorders, such as sickle cell
Plasma Transfusion Burn patients
Shock
Bleeding disorders
Platelets Cancer treatments
Organ transplants
Surgery
Fresh Frozen Plasma (FFP) transfused to trauma patients and patients with
severe liver disease or multiple clotting factor
deficiencies.
Cryoprecipitate Hemophilia
Von Willebrand disease (most common hereditary
coagulation abnormality)
Rich source of Fibrinogen
DECIDING WHETHER A TRANSFUSION IS APPROPRIATE

To determine if a transfusion is appropriate for a particular patient there are a number of points to
consider. Firstly, you should explore whether any alternatives to the procedure are available. For example,
for patients having surgery, intravenous and/or oral iron may be sufficient to enable the patient to recover.
Other alternatives for surgical patients are Tranexamic acid, suited to patients who are expected to lose
more than 500ml of blood. Intra-operative cell salvage with tranexamic acid can also be used in cases
where patients will lose a very high volume of blood. This is generally used during procedures such as
cardiac and complex vascular surgery, pelvic reconstruction, scoliosis surgery or major obstetric
procedures.
Blood transfusions can be necessary when treating certain conditions or undergoing medical procedures.

There are five key indications that a blood transfusion would be the best course of action:

Tissue perfusion needs to be maintained because of a reduction in blood volume
Coagulation is not working as well as it should, so platelets, coagulation factors or other plasma
proteins need to be replaced
Oxygen capacity of the blood needs to be increased
There has been excessive destruction of cells, for example as a result of disease.
Significant blood loss (bleeding or trauma, or inadequate production of blood or a component).

Transfusion is a serious procedure with a number of risks and an assessment to transfuse must be made
very carefully.

The decision to transfuse must be based on a thorough clinical assessment of the patient and their
individual needs.
Information relating to the appropriate use of blood components is not included in this guideline.

For more detailed guidance refer to the following BCSH guidelines:
- The clinical use of red cell transfusion (2001)
- Guidelines for the use of platelet transfusions (2003)
- Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant (2004) and
erratum (2007)
- Transfusion guidelines for neonates and older children (2004) and erratum (2007)
- Guidelines for management of massive blood loss (2006)
-
The decision process leading to transfusion should be documented in the patients clinical record.

PATIENT CONSENT

Before a decision is made to give a blood transfusion to a patient, an assessment will be made to ensure
that the transfusion is appropriate and that the patient gives consent to go ahead. As well as the medical
assessments of the patients condition which will indicate which blood component is required, it is really
important to take all the time needed to fully explain the procedure to the patient. This means not only
talking them through step by step how the transfusion will be given, but also explaining the reasons why it
is being suggested, the anticipated benefits and also any potential risks (including adverse reactions).

The hospital or medical centre you are working from may have their own information, forms and guidance
on blood transfusions. You should be shown these when you begin working at the hospital or medical
centre or if you are relocated in an area where transfusions are likely to be administered. Although
ultimate responsibility lies with your employers, you are personally responsible to make sure you are using
current information prior to administering blood or component transfusions.

Obviously your local procedures should be followed carefully, but if you can identify any areas for
improvement then you should discuss these with your line manager. Having a written checklist of things to
cover can help you ensure that conversations are recorded accurately in the patients record. If, for any
reason, you were not able to inform the patient before the transfusion took place, then once they have
regained consciousness you will need to provide full, accurate information about the procedure. This is
very important, because a patient may go on to donate blood in the future, not knowing they have
received a blood transfusion.

PATIENT REFUSAL

Every patient has the right to either give informed consent to a blood transfusion, or to refuse. Their
decision must be clearly recorded in the patients medical record. This is essential to ensure that patients
wishes are followed regarding blood transfusion. Some people may refuse a transfusion for religious
reasons, or because they are not willing to take the risks associated with the process. Your duty is to
honour their choice, even if you do not agree with it. You can question the patients reasons for not
consenting, and provide more information as appropriate but you are not allowed to force them to change
their mind, or over-rule their choice. This is the same with any other medical procedure; informed consent
is essential. Obviously, this may pose an ethical dilemma for you from time to time, and you should seek
the support of your line manager to help you resolve these issues.

If a patient is unconscious and cannot consent, then emergency life-saving treatment must be performed.
No one else can give consent if the person normally has the mental capacity to understand the risks,
benefits and outcomes of a transfusion. Just because someone is unconscious does not mean someone
else can consent on their behalf.

If a person is adamant that they do not want a transfusion or blood component, they will normally have
completed an advanced decision document. These documents can normally be found either on the patient
or in their medical file and they must be respected at all times if they are valid. A prior advanced design
document is the only reason that a transfusion cannot be given in a critical or life threatening situation.
The most common group of people globally that refuse either blood or blood component transfusions are
Jehovahs Witnesses. As with all groups of people, each person may have made an independent decision
about the medical care they are willing to accept. You must never assume that they are going to refuse all
treatment because of their belief. Most Jehovah Witnesses will have a clear document either on their
person or on their medical record of the components that they are willing to receive and this must be
followed. If you are at all unsure, seek guidance from the clinical lead or your line manager.

PROCESS FOR THE SAFE AND EFFECTIVE ORDERING OF BLOOD COMPONENTS

It is important to take care to correctly order the blood to transfuse to your patients. A process known as a
group and save should be used, which involves finding out the patients blood type and a laboratory test
screening to check for antibodies which cause common transfusion reactions. As well as this the sample
from the patient should be cross checked with the potential donors blood, mixing them in the laboratory
to try and rule out the potential for adverse reactions.

In the event of an emergency, there may not be time for the laboratory to process the cross matching, so
ensure you that you liaise with the medical/clinical team as soon as possible and adhere to your internal
policies. If you are not aware of the in house policies or protocol regarding the aforementioned, ensure
you discuss with your line manager so they can verify that you have understood the processes required,
and seek further training if you have any concerns about how to follow local policies regarding blood and
component transfusion. Never carry out duties or tasks where you are not deemed competent in nor have
received appropriate training.

Blood must be prescribed on a Prescription Chart or Transfusion Record (TR) that contains the patients ID
number, surname, first name and date of birth. The prescription must state the name of the blood
component/ product to be transfused, the volume to be transfused and rate of transfusion. This will be
carefully matched with the information used to order the blood from the laboratory or storage area. This
information will be cross checked at every stage of the process so it is of the utmost importance that it is
correctly recorded and checked from the start.
You must also include the patients details, their medical condition and gender along with the time,
urgency of transfer and location. If there are any known medical issues such as reactions or allergies. If
there are any special requirements, these must also be included on the request.
The current guidelines recommend that non-urgent out of hours requests are avoided to reduce errors.
Equally, using the telephone to request blood should not be standard practise as there is too large a
margin for error.

SHOT or Serious Hazard of Transfusion is an independent organisation that monitors the safety and
hazards of blood transfusion. The organisation collate data on reactions and adverse events and identifying
risks and underlying problems. The website can be viewed at: http://www.shotuk.org/ with resources on
how to report issues, view their data and associated information. If you are involved in a transfusion where
there are complications, you may be required to complete the SHOT report.

The NHS has listed 10 Transfusion commandments which must be central to any decision you make about
a transfusion for any patient:

1. Transfusion should only be used when the benefits outweigh the risks and there are no appropriate
alternatives.
2. Results of laboratory tests are not the sole deciding factor for transfusion.
3. Transfusion decisions should be based on clinical assessment underpinned by evidence-based clinical
guidelines.
4. Not all anaemic patients need transfusion (there is no universal transfusion trigger).
5. Discuss the risks, benefits and alternatives to transfusion with the patient and gain their consent.
6. The reason for transfusion should be documented in the patients clinical record.
7. Timely provision of blood component support in major haemorrhage can improve outcome good
communication and team work are essential.
8. Failure to check patient identity can be fatal. Patients must wear an ID band (or equivalent) with
name, date of birth and unique ID number. Confirm identity at every stage of the transfusion process.
Patient identifiers on the ID band and blood pack must be identical. Any discrepancy, DO NOT
TRANSFUSE.
9. The patient must be monitored during the transfusion.
10. Education and training underpin safe transfusion practice.


HB Blood Component Transfusion Mod1 Rev01

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

HB Blood Component Transfusion Mod1 Rev01

Uploaded by

Copyright:

Available Formats

BLOOD

Blood or component type Key uses

You might also like