1 / 20

Transfusion awareness

Learn about the importance of transfusion awareness and the proper practices for prescribing, storing, and administering blood products. Understand the risks and potential complications of transfusions to ensure patient safety.

brebecca
Download Presentation

Transfusion awareness

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A bloody lesson! Transfusion awareness SPOTs

  2. Why do patients get transfused? • Red blood cells (RBC) • To treat symptomatic anaemia • To increase oxygen carrying capacity • To treat blood loss • Fresh Frozen Plasma (FFP) • To replace certain clotting factors during bleeds • Platelets (Plts) • To correct a low platelet count • To boost poorly functioning platelets • To combat bleeding/coagulation • Cryoprecipitate (Cryo) • To treat massive bleeds • To treat DIC Transfusion awareness SPOTs

  3. When to transfuse Transfusion awareness SPOTs

  4. When to transfuse • Always take samples from limbs that are not receiving any other type of infusion. Blood samples taken from limbs receiving clear fluids will be diluted, rendering inaccurate . results, this often leads to unnecessary/over transfusions (externally reportable to SHOT). • Always suspect and re-check spurious blood test results that don’t appear to match clinical symptoms prior to prescribing a blood transfusion. • Normal Hb = 140g/l – 180g/l (Men) 120g/l – 160g/l (Women) • Hb between ‘normal’ and 70g/dl should be investigated and treated but not necessarily with a blood transfusion. Transfusion awareness SPOTs

  5. Samples Never pre-label sample bottles Always have the request form available pre-bleed Always identify your patient Always label the sample before leaving the patient Second samples About 1 sample a month is sent through to Blood Bank which shows a different blood group to a sample previously tested for that patient! (We know that wrong patients are being bled regularly – a potentially fatal mistake!) 2 samples must be taken on 2 different occasions ideally by 2 different people (to guarantee the right patient has been bled = safety measure) Do not take 2 samples at same time and use 2 different pens (we can tell!) Do not take 2 samples at same time but put different times on bottles (defeats the object!) Transfusion awareness SPOTs

  6. How to prescribe blood • Considerations: • Could I use an alternative? • Can I justify this transfusion? • What should it be written up on? • What time is it? • Consent • Patient information Transfusion awareness SPOTs

  7. How to prescribe blood • Dosage: • Red blood cells= 1 bag • Platelets = 1 bag • Cryoprecipitate = 2 bags • FFP = 3 bags • Over how long: • Red blood cells= <3 hours • Platelets = <30 mins • Cryoprecipitate= <30 mins • FFP = <30 mins Transfusion awareness SPOTs

  8. Safe storage Red blood cells (RBC): Must only ever be kept in a blood fridge An adult dose of RBC is one bag Max out of fridge time = 4 hours Must be returned within 30 minutes Every bag of RBC thrown away costs you £150 Fresh Frozen Plasms (FFP): Can be kept in a blood fridge or at room temperature An adult dose of FFP is usually 3 bags Max out of fridge time = 4 hours Must be returned within 30 minutes Every bag of FFP thrown away costs you £40 Platelets (Plts): Must be stored agitated at room temperature An adult dose of Plts is one bag Max out off the agitator = 2 hours Must be returned within 30 minutes Every bag of Plts thrown away costs you £250 Cryoprecipitate (Cryo): Must only be kept at room temperature once defrosted An adult dose of Cryo is usually 2 bags Max time from thawing = 4 hours Must be returned within 30 minutes Every bag of Cryo thrown away costs you £250 Transfusion awareness SPOTs

  9. Pre-transfusion checks Is the blood ready – how do I know? Is the patient ready – is it prescribed? are the obs ok? route of administration? is the patient going to be able to have it now? what time is it? Who is allowed to collect the blood? Transfusion awareness SPOTs

  10. DOUBLE CHECK! A MISTAKE COULD KILL!!!! Blood Bank label: NHSBT label: • (Must check against info brought with you) • Full name • Date of birth • Hospital number • (All this info found by comparing these 2 labels) • Check donor numbers • Blood groups • Expiry date Donor number Must be exactly the same Donor number Transfusion awareness SPOTs

  11. Blood group compatibility Red Blood Cells Platelets O (HT neg) = High Titre Anti-A and Anti-B negative FFP Cryoprecipitate - does not need to be ABO or Rh D matched. Transfusion awareness SPOTs

  12. Blood group compatibility The most compatible blood group to give to your patient is exactly the same group that they are (this includes O-ve too!) If Blood Bank issues blood that is not the same group as your patient it must display this sticker ATTENTION THERE IS A DIFFERENCE BETWEEN THE DONOR AND THE RECIPIENTS BLOOD GROUP. HOWEVER THIS UNIT IS SUITABLE TO TRANSFUSE If you do not see this sticker and you have been given a different blood group do not transfuse it – ring Blood Bank for clarification. Transfusion awareness SPOTs

  13. Tracing where the blood has gone Legally we must be able to track all units of blood and prove which blood has been given to which patient and which units were wasted It is no longer acceptable to just write ‘blood’ in the patients notes – the donation number must be recorded (use the stickers off the bags) In emergency situations this information can be entered retrospectively Even the emergency O-ve has to be traced! ? Transfusion awareness SPOTs

  14. The blood prescription chart Blood must be written up on an STH blood prescription chart Time of collection should be filled in by the person who collected it Should lead you step by step through the bedside checking and administration process Each chart has enough room for 6 bags of blood Transfusion awareness SPOTs

  15. The bedside check Two people must check ALL blood components at the side of the patient prior to putting it up for transfusion (not at the nurses desk!!!) These two people must be assessed as competent: Mistaeks Happen Person 1: A qualified nurse A qualified midwife A qualified ODP A qualified doctor Person 2: A qualified nurse A qualified midwife A qualified ODP A qualified doctor Transfusion awareness SPOTs

  16. Giving set lines Type of giving set: Blood must only ever be given through a blood giving set (integral filter) and for every different type of blood – use a different blood giving set Changing lines: Manufacturer’s instructions state a blood giving set should be changed after every 2nd unit of blood transfused Priming lines: It is not necessary to prime a giving set with anything other . than the blood (only 0.9% sodium Chloride is compatible with blood) Volumetric pumps: Where possible/when appropriate it is preferable . for blood to be given via a volumetric pump Flushing lines: On completion of the transfusion, do not flush the . . . blood giving set (don’t transfuse the contents of the filter). Type of giving set: Changing lines: Priming lines: Volumetric pumps: Flushing lines: Transfusion awareness SPOTs

  17. Minimum observations Blood observations must be clearly identifiable, and must be retained with the transfusion episode as part of the notes which must be kept for 30 years. Observations must be recorded electronically or on the observation chart & prescription chart (Minimum obs) Pre-transfusion: at least 15-30 minutes before the transfusion a . full set of SHEWS and temperature must be recorded 15 minutes after starting each unit of blood (not just red cells): . another full set of SHEWS and temperature must be recorded Hourly: (If the patient is ok) a temperature and pulse must be . . . . recorded. On completion: a full set of SHEWS and temperature must be . . . recorded Transfusion awareness SPOTs

  18. Reaction management • If a transfusion reaction is suspected you must immediately stop the transfusion • Contact doctor and nurses in charge • Re-check that the right bag of blood was put up for the right patient • Record observations every 15 minutes until episode subsides • If the blood is to come down – send it back to Blood Bank for investigation along with . . a suspected transfusion reaction form (download from the intranet) fresh samples will . also be required • Document what has happened and what has been done about it – it will need . . . . . reporting as an incident as it will go to the Serious Hazards of Transfusion! Transfusion awareness SPOTs

  19. Transfusion awareness SPOTs

  20. For more information • SPOT - Jill Rowlands (0114 27)15246 (There will be a Transfusion Practitioner where you work – Jill can put you in touch) • Lead Transfusion Consultant • Hospital Transfusion Team • Hospital Transfusion Committee • Hospital Intranet Site • Local Blood Transfusion Policy Transfusion awareness SPOTs

More Related