Indication of Blood &Blood Products Transfusion

Whole blood: When having acute massive blood loss of greater than 1000ml, requiring the
oxygen carrying properties of RBCs and the volume expansion provided by plasma. It should be
transfused within 2-4 hours.
Packed Red Blood Cells: Restoration or maintenance of adequate organ oxygenation with
minimal expansion of blood volume. It should be transfused within 2-4 hours for adult and 2 to 5
ml/kg per hour for pediatric.
Platelet concentrates: Prevention or resolution of hemorrhage in patients with thrombocytopenia
or platelet dysfunction. It should be transfused within 30-60 minute.
Fresh frozen plasma (FFP): Treatment of blood loss or blood clotting disorders related to liver
disease and failure, Disseminated intravascular coagulation (DIC) and Over-anticoagulation with
warfarin. It should be transfused within 15- 30 minutes.
Cryoprecipitate: Correction of deficiencies of factor VIII and bleeding due to hemophilia or
DIC. It can be completed within 3 to 15 minutes.
Granulocyte: Treatment of life-threatening bacteria or fungal infection unresponsive to other
therapy in patient with severe neutropenia. It should be transfused within 30 minutes.

Procedure: Preparatory Phase:

1. Check the doctor's order.
2. Note: telephone/verbal order for blood request is not accepted
3. Identify the patient, for pediatric and geriatric patient, ask the parents/family
4. Explain the procedure and secure signed consent in medical record.
5. Verify patient blood type and cross matching sample result less than 72 hours.
6. Note: Verification must be performed by TWO Registered Nurses and a physician.

7. Verify patent IV access:

For adults18-20 gauge
 For pediatrics 22 gauge
For neonates 24 gauge
8. Obtain the blood and inspect it for any abnormality then counter check with the physician
and two registered nurses.
9. Check the vital signs
10. Wash hands and prepare the following equipment:
Blood transfusion set IV Set and IV stand sterile gloves/PPE is recommended 0.9%
Normal saline Blood or blood component way stopcock
11. Blood warmer or wrapping towel, warm the blood