COP 3: Documented procedures define rational use of blood and blood
products.
When a patient may require blood/ blood
components staff is follows the following step
a. To ensure
patients safety, blood / blood components should not be prescribed unless there
is a real indication.
b. Request should
be made by a consultant/doctor working in the hospital.
c. Consent for
transfusion should be taken from patient / guardian after explaining the
transfusion requirement.
The priority of
the request must be indicated
STAT – product for transfusion required
or potentially required in approximately 1 hour
ASAP – product for transfusion required
within 4 hours
-------------------------------------------
than 4 hours
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SN
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Procedure
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Responsibility
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1
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After identifying the need by treating Doctor, blood
and blood products are ordered. Take Consent from patient /Patient relative
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RMO/
Consultant
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2
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Priority of the request must be indicated. i.e. STAT,
ASAP, Routine
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RMO
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3
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DELIVERING
BLOOD TO THE PATIENT AREA
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|
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Blood should be requested from blood bank after
confirming the availability from blood bank only when the patient is ready to
be transfused.
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RMO
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4
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BEFORE BLOOD
& BLOOD PRODUCT ADMINISTRATION
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|
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Numbers of blood units in need are Identified keeping
the patient condition in view. Inspect for abnormal color, cloudiness, Clots
and excess air.
Check with compatibility slip to ensure that the
following information on the unit of blood is the same as that on the Blood
compatibility slip:
Blood unit number
Collection date
Expiry date
ABO blood group and Rh group, HIV, Hepatitis B,
Hepatitis C
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Consultant
and RMO
RMO/Nurse on
duty
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5
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Prior to requesting the transport of blood products, ensure:
The patient has an IV line established with saline and
The physician orders for transfusion have been
documented and Informed consent has been obtained.
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RMO/Nurse on
duty
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6
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Aseptic technique and Universal Blood and Body
Substance Precautions will be followed throughout; hand washing will be in
accordance with the policy.
Each unit of blood will be checked at the Bedside by a
nurse and a doctor, and documented.
Rate of transfusion:
Adults; Start with 1 ml/min for first 15 minutes.
If no reaction, increase to 4ml/minutes after 15
minutes.
For Pediatric Transfusions, take advice of Treating Pediatricians.
If patient shows evidence of a transfusion reaction
immediately discontinue the transfusion at canulla hub and start infusion of
0.9% Sodium Chloride and inform the physician responsible for the case/on
duty.
The transfusion reaction from duly completed should be
returned to the blood bank along with samples for investigations as
instructed on the reaction form.
If no evidence or reaction and vital signs are stable
after 15 minutes, adjust flow to prescribed rate.
No medications or solutions may be added to or infused
through the same tubing as blood components, except 0.9% Sodium Chloride
Duration of a blood transfusion should not normally
exceed four hours per unit of blood.
If a longer infusion time has been ordered, blood bank
should be notified so that blood May be separated into more than one bag.
Discard unused blood as per discard policies (See
Biomedical Waste Management Policies).
Documentation &Reporting Transfusion reporting
Assess vital signs one hour after transfusion and as
necessary thereafter; continue to observe patient for delayed transfusion
reactions.
Document on intake and Output sheet:
Amount of blood transfused
Blood unit and number
Start and finish time of transfusion
Amount of saline infused, if necessary
Document in Nurses’ Notes the patient’s
Response to the transfusion.
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Nurse
RMO/Nurse on
duty
Nurse
Nurse
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