Page 239 - pathology_services_handbook_5th_edition_2018

9.0 MONITORING FOR BLOOD TRANSFUSION

a. Ensure the blood collected is for the patient intended (theinfo between blood,
request form and PPDK cardhas to tally)
b. Transfusion process
• Blood must be check JUST BEFORE the transfusion at the bedside, by two TRANSFUSION
clinical staffs.
• Fill in the checklist after checking the blood.
• Ensure patients received the right blood by checking the blood bag against
request form, PPDK card, patient’s wrist band/patient ID and verbal
confirmation with the patient.
• Check each unit the same way just before it is transfused.
• Vital signs (BP, HR, Temp) must be taken before transfusion of each unit.
• Close monitoring for the first 15 minutes, then every half to one hour (if no
complications).
• Avoid transfusion in the evening or nights unless inan emergency situation.
• Document the details of the transfusion (vital signs, blood units transfused,
reactions).
• Complete the PPDK card only after transfusion is finished.
• Fill in the necessary details and sign the card. This can be done by
doctor or staff nurse.
• Return the card with the used blood bag to blood bank (BB).
• Stop the transfusion immediately if the patient shows any reaction. Resume
transfusion only if the reaction is mild and not due to red cell incompatibility,
TRALI and bacterial contamination and the patient benefit from medications
given e.g. antihistamine or antipyretic agents.
• Investigate all reactions.
• Return all used blood bags to Blood Bank – empty or not, and any unused
blood units.
• Should the patient needatransfusionand the blood has been returned, make
a fresh request.

229