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CLINICAL

TRANSFUSION
PROCEDURES

BLOOD TRANSFUSION (1)

A blood transfusion is a safe,


common procedure in which
blood is given to you through an
intravenous (IV) line in one of
your blood vessels.

BLOOD TRANSFUSION (II)


Purpose :
replace blood lost during surgery
or due to a serious injury.
can't make blood properly
because of an illness.

SAFE TRANSFUSION
RIGHT BLOOD, RIGHT PATIENT,
RIGHT TIME AND RIGHT PLACE

Each hospital should ensure that the following are in


place.

1. blood request form.


2. blood ordering schedule for common
surgical procedures.
3. Guidelines on clinical and laboratory
indications for the use of blood, blood
products and simple alternatives to
transfusion
4. Standard operating procedures for each
stage in the clinical transfusion process
5. The training of all staff involved in the
transfusion process to follow standard
operating procedures

HOW TO GET THE RIGHT BLOOD TO THE


RIGHT PATIENT AT THE RIGHT TIME ?

1. Positive patient identification


Positive

patient identification : Last


name, first name, date of birth,
unique identification number.
Whenever possible ask patients to
state their full name and date of
birth at the bed side
All paperwork relating to the patient
must include, and be identical in
every detail, to the minimum patient
identifiers on the identity band.

Handbook of transfusion medicine 5th edition.2013.safe transfusion-right blood,right


patient, right time, and right place

2. Patient information and


consent for transfusion
Where

possible, patients(and for


children, those with parental
responsibility) should have the
risks, benefits and alternatives to
transfusion explained to them in
a timely and understandable
manner.

Handbook of transfusion medicine 5th edition.2013.safe


transfusion-right blood,right patient, right time, and right

3. Pre-transfusion
documentation
dataset in patients clinical record:
1.Reason for transfusion (clinical
and laboratory data).
2.Summary of information provided
to
patient
(benefits,
risks,
alternatives) and patient consent.
3.The components to be transfused (incl
: volume and rate)
4. Any special requirements
Handbook of transfusion medicine 5th edition.2013.safe transfusionright blood,right patient, right time, and right place

4. Prescription (authorisation)
The

transfusion prescription
must contain the minimum
patient identifiers and specify:
Components to be transfused
Date of transfusion
Volume/number of units to be
transfused and the rate or
duration oftransfusion
Special
requirements
(e.g.
Handbook
of transfusion medicine
5 edition.2013.safe
transfusionirradiated,
CMV
negative).
right blood,right patient, right time, and right place
th

5. Requests for
transfusion
Must include:
Minimum patient identifiers and
gender
Diagnosis, any significant comorbidities and reason for
transfusion
Component required,
volume/number of units and
special requirements
Time
andmedicine
location
of transfusion
Handbook
of transfusion
5 edition.2013.safe
transfusionth

right blood,right patient, right time, and right place

6. Blood samples for


pre-transfusion testing
All

patients being sampled must be


positively identified.
Collection of the blood sample from the
patient into the sample tubes and
sample labelling must be a continuous,
uninterrupted event involving one
patient and one trained and competency
assessed healthcare worker.
Sample tubes must not be pre-labelled.
The request form should be signed by
the person collecting the sample.
Handbook of transfusion medicine 5th edition.2013.safe transfusionright blood,right patient, right time, and right place

7. Collection and delivery of blood


component to clinical area
Before

collection, ensure the patient (and staff)


is ready to start transfusion and there is good
venous access.
Only trained and competent staff should collect
blood from transfusion laboratory or satellite
refrigerator.
Authorised documentation with minimum
patient identifiers must be checked against label
on blood component.
Minimum patient identifiers, date and time of
collection and staff member ID must be
recorded.
Deliver to clinical area without delay.
Handbook of transfusion medicine 5th edition.2013.safe transfusionright blood,right patient, right time, and right place

8. Administering blood products


(i)
The

final check must be conducted


next to the patient by a trained
andcompetent healthcare
professional who also administers
thecomponent.
All patients being transfused must
be positively identified.

Handbook of transfusion medicine 5th edition.2013.safe transfusionright blood,right patient, right time, and right place

Administering blood products (ii)

WHO : the clinical use of blood handbook: clinical transfusion

Administering blood products


(iii)
The blood pack should always be inspected for signs of
deterioration:
On arrival in the ward or operating room
Before transfusion, if it is not used immediately.

WHO : the clinical use of blood handbook: clinical transfusion

Administering blood products (iv)

WHO : the clinical use of blood handbook: clinical transfusion

Handbook of transfusion medicine 5th edition.2013.safe transfusionright blood,right patient, right time, and right place

Administering blood products (v)


Use a new, sterile blood administration set containing an
integral 170200 filter.
Change the set at least 12hourly during blood transfusion.
Use a fresh blood administration set or special platelet
transfusion set, primed with saline. All blood components can
be slowly infused through smallbore cannulas or butterfly
needles, e.g. 21 to 25 G. For rapid infusion, largebore
cannulas, e.g. 14 G, are needed
It is not necessary to prime or flush blood administration sets
with physiological (0.9%) saline but a new administration set
should be used if blood components are followed by another
infusion fluid1
Drugs should never be added to a blood component bag. 1

1. Handbook of transfusion medicine 5th edition.2013.safe


transfusion-right blood,right patient, right time, and right place
2. WHO : the clinical use of blood handbook: clinical transfusion

9. Monitoring the patient

WHO : the clinical use of blood handbook: clinical transfusion

10. Completion of transfusion


episode
If

further units are prescribed,


repeat the administration/identity
check with each unit.
If no further units are prescribed,
remove the blood administration
set and ensure all transfusion
documentation is completed.

Handbook of transfusion medicine 5th edition.2013.safe transfusionright blood,right patient, right time, and right place