The following tools are intended to assist blood users with best transfusion practice.
How to perform a pre-transfusion bedside check
• Two staff members must be present – one reads the information out aloud and the other checks it is correct.
• Start by asking the patient ‘what is your name?’
• Check that the patient’s name, surname and date of birth are the same on the issue document, product and folder.
• Check that the patient’s blood group is the same on the product and issue document.
• Check the expiry time of the product.
• Inspect the product for clots and leaks.
• Make sure that pre-transfusion vital signs are taken before the transfusion starts (ie. pulse, blood pressure, temperature, respiratory rate).
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Please return unused red cell concentrates to the blood bank:
• Within 24 hours from the time issued.
• Provided the unit remains attached to the hamper rod with the cable tie.
• The storage temperature is between 2 ºC – 10 ºC.
Top tip: Only cut the cable tie attaching the product to the hamper rod just before it is used.
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Principles to consider before transfusing your patient:
• Consider clinical symptoms, not haemoglobin triggers alone.
• Don’t give red cells for iron deficiency anaemia without hemodynamic instability.
• Give single red cell transfusions for non-bleeding patients.
• Reassess your patient before ordering additional units of blood.
• Avoid excessive blood sampling.
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• Make sure patient information on the form and blood sample match exactly.
• Write the information legibly or use a patient sticker.
• Make sure the doctor’s name and contact number are written on the form in the event there is a complication.
• Always include the date and time when the crossmatch blood sample was taken, along with who took the sample – the sample must be less than 48 hours old.
How to label a crossmatch blood sample
• Use a 6ml or 4ml powder-coated EDTA tube.
• Verify patient identity by asking their name and date of birth.
• Label the tube after taking the sample but before leaving the bedside.
• Place sticker vertically along the tube otherwise clearly write the patient’s name and surname, along with another identifier (date of birth, ID number or hospital folder number).
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In the event of a suspected reaction:
• Stop the transfusion immediately.
• Call for assistance and notify the patient’s doctor.
• Keep venous access open for the patient with normal saline using a new drip set.
• Manage the specific reaction (eg. allergic reaction, fever, dyspnoea).
• Check that the correct blood product was transfused to the patient by verifying their identity and comparing this to the details on the product.
• Once the patient has been stabilised, notify the blood bank.
• Return all used and un-used blood products, including the giving sets, to the blood bank along with two post-transfusion EDTA patient samples.
• Complete the doctor’s report supplied by the blood bank or available here
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