Before a transfusion:

1. Is a pre medication required?
2. Do you have sufficient resources to manage the transfusion?
• Overnight transfusions in particular are discouraged unless clinically urgent or in a high-resource area eg theatre, ICU, APU. Errors are more likely at night, monitoring is more difficult and the patient becomes sleep-deprived.
3. Are there any other special requirements? (eg CMV negative or irradiated)
4. Has consent been obtained? (more info on consent)
5. Has suitable venous access been obtained?
6. Has the component been checked against the patient?
   • The patient has stated his/her name him/herself
   • The patient's wristband has been checked against the unit's label
   • Identification details on the blood component and label match the identity of the patient
   • The unit's blood group is compatibility with the patient's blood group (on the compatibility label) (see component's details for compatibility)
   • A second person has independently confirmed this check at the bedside
   • For more detail, see Bedside Checking.

Compatible Intravenous Solutions

• Use only 0.9% Saline.
• DO NOT use 5% Dextrose solutions (may induce haemolysis)
• DO NOT use Lactated Ringer's or other balanced salt solutions that contain Calcium, as this may induce clot formation in the blood bag and / or administration set.
• Never add medications to blood components and products.
• Never piggyback a blood transfusion onto another line containing medication.

More Info

• Transfusion Medicine Handbook
• NZBS Clinical Compendium