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Check list for blood products transfusion

Check list for blood products transfusion
 Before ordering blood product transfusion
Able to decided that a patient is indicated for transfusion
Able to assess patient general condition and hemodynamic stability
Ask about any previous transfusion reactions
Check blood group and Rh of the patient
Able to order the proper type of blood products according to patient condition
Check policies for special patient groups
Explain the procedure to patient and get written consent
Blood collection order form is completed including:
 Patient ID
 Blood group and Rh of patient
 Type of needed blood product
 The number of required unites per transfusion
 Signature of personnel who withdrawn the sample
 Signature of medical staff who order the transfusion
 Before giving the blood product to the patient
Draw blood from the patient and put it into a non-anticoagulated tube that not
contains a serum separator gel for cross matching.
Able to do cross match procedure on a blood product
Check that the cross match blood sample label is signed by the individual drawing
the blood sample and contain patient ID.
Able to determine the number of units needed for transfusion
Able to order blood bank to perform “sickle preparation” when a transfusion is
being performed in infants and patients with known sickle cell anemia
Able to write order form for blood product transfusion correctly
Proper identification of the patient before blood administration
Check the identity of the numbered blood product labels before administration
Check that blood bank identifies the patient by name and number and contain
the identification number of the unit of blood.
Make separate blood bank request form for each unit of blood ordered.
Do not open a unit of blood unless a free-flowing iv access line has been
established in a large-bore vein.
If the patient already has a suitable iv line in place, flush the system with a
solution of normal saline before administering the blood.
Do not place any medications in the unit of blood or infusion line for the same
 During blood product transfusion
Check the patient ID and blood product label ID
Check the collection date and expiry date of blood product
Check that blood bag is intact, no clots or discoloration
Use an appropriate filter for blood product transfusion
Write the time of start and finish of transfusion in patient record notes
Replace standard filters after 2 to 3 units of blood product have been
Change microaggregate filters after each unit.
Give written order for the rate of infusion
If a transfusion of blood will be interrupted or delayed, return the remainder of
the blood unit to the blood bank.
Rewarming blood to 35°c to 37°c before transfusion.
Careful monitor during the first part of the transfusion of any blood product for
evidence of a transfusion reaction.
Monitor for the following signs and symptoms during transfusion:
 Hives
 Chills
 Diarrhea
 Fever
 Pruritus
 Flushing
 Abdominal or back pain
 Tightness in the chest or throat
 Respiratory distress.
 Monitor for pulse
 Monitor for blood pressure
 Monitor for respiratory rate
 Monitor for temperature
If developed allergic reaction, administer antihistamine (but not in the blood
infusion line), and stop the transfusion.
Able to early identify and manage hemolytic transfusion reaction
If develop acute hemolytic transfusion reaction, alkalinize the urine with iv
sodium bicarbonate and do force diuresis with mannitol to maintain urine output
at 50 to 100 ml/hr.
Stop the transfusion immediately when the following signs are encountered:
 An increase in pulse rate, a decrease in blood pressure
 Respiratory symptoms
 Chest or abdominal discomfort
If patient suspect reaction to transfusion product
 Stop the transfusion immediately
 Administer normal saline to maintain blood pressure and urine output.
 Send samples of urine and blood to the laboratory to verify the presence
of free hemoglobin.
 Send the blood bank a clotted sample of blood to reassess for immune
Able to identify delayed, or “late,” hemolytic transfusion reactions
Instruct individuals with previous transfusion reactions to wear identification
tags or bracelets to alert medical personnel
On completion of a transfusion make an entry in the patient’s record to indicate:
 The type of the transfusion
 The volume of the transfusion
 The presence or absence of any reaction.
If developed non hemolytic allergic response, pre medicate with antihistamines
and antipyretics before the next transfusion or use washed cells.