- All transfusions should be monitored in accordance with established guidelines and your DHB blood policy.
- Baseline observations, taken within the 60 minutes before the start of the transfusion: check temperature, pulse, respiration rate and blood pressure.
- Remain in the room or in immediate proximity for the first 15 minutes of the commencement of each unit
- For each unit:
- The commencement time of the transfusion must be documented.
- The patient MUST be closely observed for the first 15 minutes after commencement of each unit and SHOULD be closely observed throughout the transfusion.
- Where the patient is not in an open area that allows continuous visual observation, consideration should be given to attending the patient for the first 30 minutes of the transfusion.
- As a minimum, the vital signs of temperature, pulse, respiration rate and blood pressure MUST be measured and recorded as follows:
- Prior to the start of each individual blood component pack administered.
- 15 minutes after commencing administration of each blood component pack.
- When administration of each blood component pack is completed.
- There is no consensus on subsequent frequency of routine vital sign measurement, however many institutions stipulate hourly measurements, after the initial 15 minute period, until completion of the transfusion. Please consult the DHB's blood policy.
- Additional vital sign measurements, including oxygen saturation, may be required by departmental or hospital policy.
- The frequency and recording of vital signs must be adjusted according to the individual patient's clinical condition. with more frequent monitoring based on underlying comorbidities and intercurrent factors.
- All observations must be recorded in the patient's medical/clinical record.
- After each unit: record pulse, blood pressure, respiration rate and temperature and visual observation of the patient's appearance and condition.
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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).
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