BLOOD

TRANSFUSI
ON
BLOOD TRANSFUSION
ORDERS
 There must be a written order by the physician for the blood

transfusion
 Telephone and verbal order during urgent situations must be

followed by written request

 The physician order must clearly identify product (PRBC,PLT,

FFP or CRYO), patient (Name and patient ID) and process

(timing, flow rate, blood warmer, infusion device)

 The physician order for transfusion must be carefully

transcribed onto blood transfusion requisition providing

sufficient information for positive patient identification. Also,

the name of the ordering physician, the patient’s diagnosis and

the reason for transfusion must be indicated on the blood

transfusion requisition
PATIENT BLOOD SAMPLE
 Blood specimen must be obtained from the patient within
3days of the scheduled transfusion considering day 0 is the
day of draw the maximum interval during which a recipient
sample may be used for blood bank.
 Patient identification wristband must be placed on the
patient prior to specimen collection and remain on the
patient until discharge
 For compatibility testing, a full 7ml lavender top tube (EDTA)
is required. A minimum volume of 3ml from an adult.
 All tubes submitted to Blood Bank must be hand written and
labeled at the Bed-Side with (Patient’s name and patient’s
ID, Collection date, Collection time, nurse signature and
collected under the name and ID of the person who draws
the specimen)
 All samples submitted to Blood Bank must be accompanied
with the request form. In case of discrepancy or doubt, it is
the responsibility of the Blood Bank staff on duty to request
clarification, correction or redraws
AS PER POLICY…
 All equipment used for blood transfusion must be kept in top

working condition by performing the manufacturer-

recommended preventive maintenance and quality control

 Blood and blood components must be administer through the

plastic tubing supplied by the manufacturer of the approved

infusion device
 Blood warming may be indicated at flow rates of

>50ml/kg/hour in adult, >15ml/kg/hour in children and for

exchange transfusion in infants

 Blood warming devices must not raise the temperature of

blood/component above 38⁰C

 Blood warmers should have a visible thermometer, and an

audible alarm set to sound before the 38⁰C limit is exceeded

AS PER POLICY…
 Electromechanical infusion devices (mechanical pumps that deliver

infusions at a controlled rate) can be used if the device is licensed

for the infusion of blood and blood products. The manufacturer of

the infusion devices and the Blood Transfusion Committee must be

consulted before blood is administered through an infusion pump

designed for crystalloid or colloid solution

 Intra-operative and post-operative blood collection devices used to

recover blood from the operative site for reinfusion to the patient

during or after surgical procedure can be used provided the

indications, contraindications; quality control and operating

procedures are in accordance with the AABB standards and

reviewed and accepted by Blood Transfusion Committee

COMPATIBLE IV
SOLUTIONS
 Medications must not be added to blood or blood
components
 If a component needs to be diluted to reduce its
viscosity or if a component needs to be rinsed from
the blood bag or tubing, normal saline (0.9%
sodium chloride injection, USP) is the only product
of choice
 Drugs or other materials may be added to
blood/blood products only if documentation exists
that no harm will result to the component or
patient
 Blood/blood products must be transported in a validated transport
containers dispensed by the Blood Bank
 Blood temperature should be indicated at releasing and returning the
blood unit to blood bank
 Issued Blood/blood products must be delivered to the patient care unit
without deviation from the direct route (no stops at the pharmacy,
central stores or the cafeteria) to avoid the prolonged warming of the
blood/blood components
 Unused donor units must be returned to Blood Bank within 30minutes to
avoid wastage
 Released blood/blood products should not be exposed to extreme heat
 Between the release and the start of the transfusion, blood/blood
products must be kept in the transport container at room temperature
 PRBCs and FFP released to OR must be immediately (in less than
30minutes) stored in the designated blood refrigerators
 Between the release and the start of the transfusion, Cryoprecipitate
and platelet concentrate released must be kept in the transport
container at room temperature
 TRANSFUSION
RECORD
 For each unit of red blood cells, pheresis platelets,

fresh frozen plasma, and - cryoprecipitate to be

administered, vital signs (blood pressure, pulse, and

temperature) shall be obtained and documented on

the Transfusion Record:

 Prior to transfusion
 Every five minute for the first fifteen minutes

after initiation of the transfusion, every 15

minutes for the first 30 minutes ,every 30

minutes for the 1st hour and Hourly until

completion of the transfusion(s).

THANK
YOU!