Administration of blood products (bsh 2017)
RBC +4oC +/-2
Platelets +22oC +/-2
FFP / Cryo -25oC
4 ABO incompatible red cell transfusion, 606 ABO-incompatible near-miss events
Blood component = a therapeutic constituent of blood (RBC,plt,FFP,Cry,Gran)
Blood product = a medicinal product derived from whole blood (Alb, SD-FFP)
Regulate who is competent to collect blood from storage locations
Vein-to-vein journey and use of electronic information management
Printed wristbands – minimum of 1st and last name, DOB + unique identifier No.
Positive patient identification at every step
Collection from storage and delivery to clinical area
Administration to patient
For patients unable to identify themselves, it is acceptable to ask relative/carer if they are present at the bedside. Local policies should otherwise be followed.
For unknown patients
Must have ID band with temporary ID number + patient’s gender as a minimum
Temporary numbers should be issued non-consecutively to minimize error.
Bar-coded IT systems should be used
Complete documentation must enable an unambiguous audit trail
All paperwork must have the minimum patient identifiers
Full traceability must be possible for every unit transfused.
Indication for transfusion and & document consent process
‘Will I need a blood transfusion?’ Patient information leaflet
Date, product, volume, rate, special requirements and additional meds
NOT a medicinal product, no national legal barrier to who ‘prescribes’ blood
Clear and unambiguous communication policies must be in place – written or electronic
Clinical, laboratory and support staff all involved
Training and Competency
All staff need minimum 3 yearly training
Theory and knowledge
Practical observed competency
Competency assessment conducted as per individual UK countries and MHRA requirements
Returning units to storage
If <30 minutes: Can return directly to the issue location
If 30-60 minutes: Can return to quarantined fridge for min. 6 hours then re-issue
Max 3 occasions of being removed for 30-60 minutes allowed.
Thawed FFP can be accepted back into a fridge (2-6oC) if this occurs on one occasion of less than 30 minutes.
Any returned units can only be re-issued if the transfusion will have completed within four hours of the original first issue time.
SD-FFP and MB-FFP
No guidance issued on returns to storage
Cannot be refridgerated and so must be used within 4 hours of issue. Could be returned to ambient temperature storage if re-issued and transfusion completed within the four hours from time of first original issue.
No interruption to agitation should last >8 hours, and the combined interruption over the unit lifespan must not be >24 hours.
Units can be returned and re-issued retaining the same shelf-life, provided that the non-agitation times are not exceeded.
Transfuse through a 170-200 micron filter
Red cells and plasma can be transfused through the same administration set
The should be changed if switching to platelets or another drug.
Complete within 4 hours of removal from temperature-controlled storage
Pre, during and post observations
Contact card for day case patients in case of complications
Patients must be informed that they received blood (e.g. surgery)
Patient’s discharge letter must include this information