PIP - 12

 
return to blood transfusion guidance

EMERGENCY PROVISION OF BLOOD FOR TRANSFUSION

  As soon as you discover a potential urgent need for blood, it is important to communicate with Blood Bank staff (ext: 3535 during routine hours) or 7080 at other times or in event of major haemorrhage

Use the nomenclature below to convey the degree of urgency and to avoid confusion.

Acute haemolytic transfusion reaction is usually due to ABO incompatibility, potential to cause patient death. The most important aspect of safe transfusion practice is to ensure ABO compatibility between the patient and donor blood.
 

ALWAYS CHECK THE PATIENT IDENTIFICATION & BLOOD GROUP

FLYING SQUAD BLOOD  -  IMMEDIATELY AVAILABLE

Group ORh(D) Negative (‘Flying squad’) blood is available for immediate use.

·         2 units in Main Blood Bank (Pathology, Basildon)

·         2 units in Basildon Maternity Blood Bank

·         2 units in Orsett Day Unit Blood Bank.

·         This blood is ABO and Rh(D) compatible with all recipients so there is minimal risk of serious acute haemolytic transfusion reaction.

·         When removing Flying Squad units, record the patient details and ensure that a sample for crossmatching is taken before administering the blood.

·         Please inform Blood Bank staff that Flying Squad units have been taken.

If the recipient has alloantibodies (which results in an incompatible crossmatch in about 3% of cases), the patient may develop a mild delayed haemolytic transfusion reaction several days later and future pregnancies may be complicated by haemolytic disease of the newborn (HDN).

In the case of a patient with an active life threatening bleed, this risk can be accepted as small compared to the risk posed by delaying the transfusion.

GROUP SPECIFIC BLOOD   -  within 10 minutes

·         ABO and Rh(D) ‘Group Specific’ blood can be issued by the Blood Bank within 10 minutes of a valid sample reaching the laboratory.

·         This blood is not crossmatched but is selected as ABO and Rh(D) compatible to the patient.

Using Group Specific blood conserves stocks of Group ORh(D) Negative blood which may become depleted.

There is no risk of ABO or Rh(D) incompatibility but about a 3% risk of incompatibility due to the presence of alloantibodies – (see Flying Squad details for consequences).

FULLY CROSSMATCHED BLOOD  -  within 45 minutes

·         Fully crossmatched ABO and Rh(D) compatible  blood is usually available from the laboratory within 45 minutes of a valid sample reaching the laboratory.

·         The crossmatch is “compatible” in about 97% of patients tested and the blood should not cause acute or delayed haemolysis due to alloantibodies.

The crossmatch may be “incompatible” in 3% of patients.

It may be necessary to transfuse “incompatible” blood units if the clinical need for blood is urgent,

If in doubt (if time allows), discuss with your Consultant and the on call Consultant Haematologist.

 

Version 1 / February 2013