Auburn Community
Hospital Policy &
Procedure:
Transfusion begins with a doctors
assessment of the patient, then a order
specifying the blood product to be infused,
the quantity, and any special requirements
required
Patient is then typed and cross matched
per the MD order
Consent form is signed prior to the
transfusion, IV access with a # 20 gauge
catheter or greater
MD order is double checked, by 2 persons
(one must be an RN) must verify the blood
unit tag, lab report, type and cross match,
and the IV solution the patient has infusing.
The expiration of the blood must be
checked
Then identify the patient asking their name
and DOB at the bedside and also verify the
patients ID band with the blood unit tag
Vital signs must be obtained prior to
infusion, 15 minutes and 30 minutes into
the infusion and at the completion of the
infusion
Normal Saline is the only solution that can
be hung with blood
During the transfusion all other IV solutions
are placed on hold unless specified by MD
No transfusion can run more then 4 hours.
Hospital policy requires a hemoglobin and
hematocrit lab work is to be ordered by the
MD within 24 hours of the transfusion
Evidence Based Practice
EBP is proposing changes in the
policy and practice of blood
transfusions
Such as needing to challenge the
thought of using a 20 gauge or
larger needle for blood
transfusion
Smaller needles did not result in
significant erythrocyte hemolysis
and managing transfusions using
restrictive transfusion strategies
Is as effective and possibly
superior to liberal transfusion
strategies
Liberal strategies is transfusing
Hgb levels that fall below 10 g/dL
Restrictive strategies is
transfusing when Hgb falls below
7g/dL
Blood
Transfusions
In patients 55 years or younger
the restrictive strategy was
clearly superior
Evidence suggests that smaller
then a 20 gauge catheter can be
used safely for transfusions
By: Erica Lang, Melissa Wise,
Scott Weigand
Why Administer Blood
Products?
Anemia is a sign of an
underlying illness of condition.
 Nutritional deficiency
 Acute or Chronic blood
loss
 Anemia of chronic disease
Why Blood
Management?
Blood Management consists of:
Hemoglobin value of 7 g/dL or
less is commonly used as a
guideline for red cell
transfusions
 Prevention
 Early Identification
 Treatment of Anemia
 Decisions to transfuse is
based on patients clinical
status
Signs and Symptoms reflecting the
need for a transfusion
Blood transfusions are
one of the most
commonly performed
procedures





.
Dyspnea
Orthostatic Hypotension
Syncope
Tachycardia
Chest Pain.
Types of Blood Products
 Whole blood
 Packed Red Blood




Cells
Platelets
Fresh Frozen Plasma
Cryoprecipitate
Granulocytes.