Guidelines for Setting Up Blood Storage Centres - NRHM Tripura

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INTRODUCTION The Department of Family Welfare is now initiating the setting up of a Blood Storage Centres at the First Referral Units (FRUs) to make blood readily available, especially at times of emergency. This service would be available to the women during and after childbirth and is expected to bring down Maternal Mortality. To establish the Blood Storage Centres, it is essential to train the medical officers and technicians working in these FRUs in the various methods of handling blood, including storage, blood grouping, cross- matching, transfusion and adverse reactions. A formal training programme of 3 days duration is envisaged for one medical officer and one laboratory technician from each of the identified FRUs where blood storage centres are to be set up. It is however considered essential, that the medical officers and also the clinicians who handle obstetric emergencies are sensitised on the important issues related to various aspects of transfusion of blood and blood products. While a Standard Operating Procedure Manual (SOPM) has been prepared for the training of medical officers and technicians, The “Clinicians Guide to Appropriate Use of Blood” has been prepared keeping in mind the needs of the clinicians who will be responsible for prescribing and transfusing blood and blood products. For this purpose, it is suggested that a one day sensitisation workshop may be undertaken in each district for the medical officers/specialists posted at FRUs. The workshop may be held at the medical colleges or in district hospitals where a pathologist/ trained blood bank officer is in position. OBSTETRIC CONDITION WHERE WHOLE BLOOD IS NEEDED Anaemia Haemorrhage Antepartum Postpartum It is estimated that about one third of all maternal deaths are due to haemorrhage, both ante partum and postpartum (SRS-1998). The National Family Health Survey 1998-99 has brought out that almost half of the pregnant women are moderately to severely anaemic. Presence of anaemia in a pregnant woman who develops haemorrhage, increases the chances of her dying, manifold. Timely transfusion of blood is thus an important intervention which can save the lives of many such women, if adequate supply of blood is available at the first referral unit level. If it is used appropriately, many women who would otherwise die, can be saved. Blood is the main oxygen carrier in the body yet it cannot be used as a tonic. The use of blood should be judicious. The benefits attached to blood transfusion should be weighed against the risks involved with transfusion of blood. Since blood cannot be sterilised, there is possibility of transmitting any agent present in red cells or plasma which has not been detected by routine screening tests for transfusion-transmissible infections, including HIV, Hepatitis B, C, other Hepatitis viruses, Syphilis and Malaria, etc. 27
CLINICIAN'S GUIDELINES Administration of red blood cells • Check the identity of patient properly before transfusion • Must be ABO & Rh D compatible with patients • Alternative blood group can be given at times, if group specific blood is not available TABLE 1b : CHOICE OF ALTERNATIVE BLOOD Alternative Blood Group Patient Blood Group First Choice Second Choice (Given as Packed Cells) (Given as Packed Cells) O None None A O None A2 with anti A1 O None B O None A1B A or B O A2B A or B O A 2 with anti A1 A 2 or B O • Transfuse within 4 hrs. • Transfuse blood within ½ hr of issue from blood storage centre. • Complete the transfusion within 4 hrs. • Blood once issued will not be received back in the storage centre. RESPONSIBILITIES OF CLINICIAN IN CASE • When and where the blood is required. THE PATIENT NEEDS TRANSFUSION Ensure the correct storage of blood and blood Inform and explain to the patient or relatives about the proposed transfusion of blood/blood products in the clinical area before transfusion. products (Benefits & Risks) and record the same in Formally check the identity of the patients, the the patient’s file. Ensure proper identity of the patient product and the documentation at the patient’s & correctly complete a blood request form. Collect bedside before transfusion. the blood sample from the right patient in the right sample tube & correctly label the sample tube. Order Correctly record transfusion in the patient’s notes: blood in advance, whenever possible. • Reason for transfusion Provide the blood storage centre with clean information on: • No. of units transfused • The number of units required • Time of transfusion • The reason for transfusion • Monitoring of the patient before, during and • The urgency of the patient’s requirement for the after transfusion transfusion • Any adverse events. 28
Page 1 and 2: Guidelines For Setting Up Blood Sto
Page 4 and 5: Foreword It is estimated that for e
Page 6 and 7: Acknowledgements The publication of
Page 8: Contents TOPIC PAGE Guidelines Intr
Page 12 and 13: INTRODUCTION There has been a signi
Page 14 and 15: (v) Consumables : There should be a
Page 16 and 17: 6. DOCUMENTATION & RECORDS The Cent
Page 18 and 19: (5) The First Referral Unit, Commun
Page 20 and 21: 9. The Blood Banks who intend to su
Page 22 and 23: ANNEXURE -II SPECIFICATIONS BLOOD B
Page 24: STANDARD OPERATING PROCEDURES
Page 27 and 28: STANDARD OPERATING PROCEDURES INTER
Page 29 and 30: STANDARD OPERATING PROCEDURES • C
Page 31 and 32: STANDARD OPERATING PROCEDURES 4. Mi
Page 33 and 34: STANDARD OPERATING PROCEDURES INTER
Page 38 and 39: Collecting Blood/Blood Components p
Page 40 and 41: DISPOSABLE EQUIPMENT For blood admi
Page 42 and 43: • Alternative blood group can be
Page 44 and 45: TIME LIMITS FOR INFUSION Blood Comp
Page 46 and 47: DEXTRAN 60 & DEXTRAN 70 • HES is
Page 48: compounds in which all hydrogen ato

Guidelines for Setting Up Blood Storage Centres - NRHM Tripura

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