Guidelines for Setting Up Blood Storage Centres - NRHM Tripura

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DISPOSABLE EQUIPMENT For blood administration Cannulas for infusing blood products 1. Must be sterile and must never be reused Blood should only be warmed in a blood warmer. Blood should never be warmed in a bowl /oven as this can result in haemolysis of red cells which can prove fatal. 2. Use flexible plastic cannulas if possible as RECORDING THE TRANSFUSION they are safer and preserve the veins Before administering blood products, it is important For Whole blood / Red cells to write the reason for transfusion in the patient’s case-notes. If the patient later has a problem that 1. Use a new sterile blood administration set could be related to the transfusion, the records containing an integral 170-200 micron filter should show who ordered the blood and why. This 2. Change the set at least 12 hourly during information is also important in conducting the audit blood component infusion of transfusion services. 3. In a very warm climate change the set more The following information should be recorded in the frequently and usually after every four units patient’s notes: of blood, if given within a 12 hour period. • Whether the patient and or relatives have been For Paediatric patients informed about the proposed transfusion treatment Use a special paediatric set for paediatric patients. • The reason for transfusion These allow the blood or other infusion fluid to flow into a graduated container built into the infusion set. • Signature of the prescribing clinician This permits the volume given and the rate of PRE-TRANSFUSION CHECK ON infusion to be controlled simply and accurately. 1. Patient’s identity Warming blood 2. Blood pack There is no evidence that warming blood is 3. Compatibility label beneficial to the patient when infusion is slow 4. Signature of the person performing the pre- At infusion rates greater than100 ml/minute, cold transfusion identity check the transfusion blood may be contributing factor in cardiac arrest. 5. Volume of blood transfused However, keeping the patient warm is probably 6. Unique donation number of each unit more important than warming the infused blood. transfused Warmed blood is commonly required in; 7. Blood group of each unit transfused Large volume rapid transfusion: 8. Time at which the transfusion of each unit Adults : greater that 50 ml /kg/hour commenced Children : greater that 15 ml/kg/hour 9. Signature of the person administering the blood Exchange transfusion in infants 10. Monitoring of the patient before, during and Patients with clinically significant cold agglutinins after the transfusion. 31
CLINICIAN'S GUIDELINES TRANSFUSION REACTIONS, if any APPROPRIATE USE OF BLOOD Severe reaction mostly occurs within the first 15 COMPONENTS minutes of the start of transfusion. So all patients Unlike earlier times, whole blood is now considered should be monitored carefully during this period. as raw material rather than transfusion medium. The This should be followed for every subsequent unit of only one indication for whole blood transfusion is blood to be transfused. exchange transfusion. The use of whole blood is obsolete and is now completely replaced by various Things to be done in the ward by the medical blood components like: officer in case of a reaction • Packed Red Cell In case of a suspected transfusion reaction the • Platelet Concentrate following things are to be done : • Fresh Frozen Plasma • Stop the transfusion PACKED CELLS • Keep IV line open Indications • Notify the physician • Severe chronic anaemia to reduce chances of • Antihistaminic and steroids to be administered overload • Constant monitoring the vitals of the patient • Hypoplastic anaemia INVESTIGATION OF A TRANSFUSION • Hemolytic anaemia especially in aplastic crisis REACTION Advantages The following samples are to be sent to the Blood Less blood group antibodies so “O” Negative blood Storage Centre along with the reaction report: (group-non- specific) can be given to patients with other groups. • EDTA Less Plasma proteins with packed cells so there are • Plain Vial minimum anaphylactic reactions. • First Urine sample after the transfusion reaction Storage : 2-6ºC • The blood bag along with the transfusion set Expiry : 35-42 days depending upon blood collection bag. Day of blood collection is taken as Whenever a transfusion reaction occurs, the doctor Zero Day. In charge should enter the following records in the patient’s file. TRANSFUSION TRIGGER • Date & Time of Reaction Transfusion requirement of each patient should be based on clinical status, rather than Hb value on • Bag No. / Unit No. Haematocrit. However, patients with haemoglobin • Patient’s ID No. levels less than 7.5 gms/dl (transfusion trigger) • undergoing surgery, should be considered for Blood group as entered in the file, patient file transfusion. and the donor (blood group on the bag issued). • Check all the labels & records for any clerical ADMINISTRATION OF PACKED RED CELLS error & also record the volume of the blood that • Check the identity of patient properly before has been transfused, and that remaining in the transfusion. bag. • Must be ABO & Rh D compatible with patients. 32
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 36 and 37: INTRODUCTION The Department of Fami
Page 38 and 39: Collecting Blood/Blood Components p
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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