1. All transfusions should be monitored in accordance with established guidelines and Southern DHB blood policy located in MIDAS 70877 the Blood Transfusion HUB.
2. Baseline observations, taken within the 60 minutes before the start of the transfusion: check temperature, pulse, respiration rate and blood pressure.
3. Remain in the room or in immediate proximity for the first 15 minutes of the commencement of each unit
4. For each unit:Repeat TPR and BP at 15 minutes. Thereafter monitor TPR every 30 minutes and BP hourly. Increase BP monitoring if condition changes. Visually assess through-out.
5. After each unit: record pulse, blood pressure, respiration rate and temperature and visual observation of the patient's appearance and condition.

Rate of Infusion and Precautions

• All Blood components (except Platelets and Cryoprecipitate) should be infused within four hours. If the transfusion of the component cannot be started immediately, return it to the blood bank for appropriate storage.
• In the routine setting (i.e. a stable patient), transfuse each unit slowly (up to 50mL/hour) for the first 15 minutes and observe the patient for any adverse reaction. Only increase the rate to the prescribed rate after 15 minutes.
• Never store blood components in the standard ward refrigerator.
• Paediatric patients should always have doses prescribed in mL, not units. If the prescription is in units, check the volume required in mL, as units vary in volume and there are different types of units (neonatal and adult).

More Info

• Southern DHB blood policy located in MIDAS 70877 the Blood Transfusion HUB
• Transfusion Medicine Handbook
• NZBS Clinical Compendium