The Communication and Transport of
Blood and samples between A/E and the Blood Transfusion
Laboratory in Emergency situations
of requests, and the transport of samples and blood
products between A/E and the Blood Transfusion Laboratory,
merits special consideration. Patients may arrive in A/E
with little means of identification, and in urgent need of
transfusion; unlike patientís in other locations, the
Laboratory will not have previously been supplied with a
Adherence to an
agreed protocol for the requesting, and issuing of blood,
is important in the effective management of initial blood
This protocol addresses potential problems that might lead
to a delay in the provision of compatible blood
A/E LINK PERSON
The nurse in
charge of Resus will be the designated link person in
A/E, who will liase with the Blood Transfusion Laboratory,
and deal with blood requests; this involves (in order of
the taking of a G&S sample at the earliest opportunity
(along with Full
blood count and clotting screen)
- Ensuring sample and request form are correctly labelled
- Arranging for the sample to be sent immediately and
directly to the Blood
Transfusion Laboratory (the Departmental assistant to wait
for blood units when
these are to be issued straightaway).
- Phone the Blood Transfusion Laboratory tel: 3535
during routine (09:00 - 17:30)
hours or other times tel: 7080 and supply the following
information to the BMS:-
1. Your name
4.Patientís A/E Number
5. Brief relevant clinical data
6. The immediate blood requirements (for first ten minutes)
7. The ETA of the G&S sample
received the first blood units, the A/E link person should
call the Blood Transfusion Laboratory to:-
Update the BMS with regard to additional requirements
(in terms of number of Group-specific
units required, and indicate time scale).
- Arrange to send the Departmental assistant back to
the Blood Transfusion Laboratory to
collect Group-specific units.
Ascertain and communicate other blood product
requirements; typically for a continuing acute
massive bleed this would mean activating the
Massive Blood Transfusion Protocol
- Update the BMS with regard to location and plans
After the first
ten units, crossmatching is no longer performed, and
Group-specific units are routinely issued. Group-specific
units can be issued at a sustained rate of 10 units
every ten minutes, while stocks last. When it seems likely
that active bleeding will continue for some time, please
notify the BMS, who will need to consider early
replacement of blood stocks.
2 Doses of platelets are kept in
stock. However, if further doses are required these are
ordered from the NHSBT on a named patient basis and takes
at 1 hour (if in stock) to obtain platelets, so it is
important to order them in a timely manner.
FFP will take 20
to 30 minutes to thaw; so it is important to order FFP
before coagulation is affected by the transfusion of large
volumes of stored blood.
The BMS in the
Blood bank, on receiving a call for Emergency Group O
Negative units will:-
- Agree to issue
the immediate blood requirements. E.g. two Emergency Group
(Flying Squad) units.
- Complete signing out documentation as per blood collection
- Place units in a Blood box or bag and send to A/E with
the Departmental assistant who
delivers the sample.
- Manually tube group the sample immediately, before
- Select and issue the required number of
- Set up the a retrospective crossmatch.
- Confirm the Blood group before releasing
- Process sample for group and screen on analyser.
notified of additional blood requirements, the BMS in the
Blood bank will:-
Prepare additional units as required; in reality in this
sort of situation Laboratory staff try to
predict and stay ahead of requests (to alleviate
pressure on themselves).
- Notify A/E liaison person once the retrospective
crossmatch is read and units are found to
- Review and order replacement red cell stocks, as
In the case of
an Acute Massive bleed, the BMS will
check stocks in accordance with the
Massive Blood Transfusion Protocol and order stock accordingly.