Instructions for blood transfusions

Preparing for a blood transfusion

• It is important to prepare for a blood transfusions, especially if the patient has a rare blood group, multiple red cell antibodies, IgA deficiency, HLA or HPA immunisation or other need for a special blood product.
• The hospital’s blood bank answers for the pretransfusion blood group testing. The Blood Service helps with the testing and choosing the right product if needed.
• More information about the blood products and their use can be found in the Finnish guidebook: Verivalmisteiden käytön opas.

Things to consider in the nursing unit before blood transfusion

• A red blood cell transfusion must be completed within 6 hours after bringing the product to room temperature.
• Platelet products must be stored and transfused at room temperature.
• The patient’s illnesses and clinical condition must be considered in the infusionrate.
• The need for pre-medication should be concsidered (e.g. antipyretic, antihistamine, diuretic).

Only handle blood products that are intended for one patient at a time!

• Make sure that the product matches the patient (blood group, compatibility test, special products such as irradiated products).
• Inspect the blood product (expiry date, colour, appearance, presence of blood clots or gas).
• All blood products are transfused using transfusion equipment fitted with a filter (150–200 μm).
• Only electrolyte solutions that do not contain calcium (such as NaCl 0.9%) may be infused via the same catheter, transfusion equipment or tubing used for administering blood products.

At the bedside

• Identify the patient and make sure that the product is meant for the patient in question.
• Start every blood transfusion with the biological pre-testing, that is slowly and monitor the patient closely, because an adverse reactions may be related to the properties of an individual blood product.
• If the patient gets an adverse reaction, stop the blood transfusion and notify the doctor.

Documentation and tracability

• The blood transfusion must be documented in detail: vital signs before and after the transfusion, the start and end time of the transfusion, the amount transferred and any possible changes in the patient’s condition.
• Store the bag and the transfusion equipment for 24 h in the fridge (close them with a stopper) and the tubing and its attachments used for compatibility testing for 3 days (marked with the product unit number and personal identity sticker).
• Return any unused blood products to the hospital’s blood centre to ensure tracability.