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The Practicalities of Blood Transfusion

The Practicalities of Blood Transfusion. You’ve Identified An Anaemic Patient (Well done you………..). How did you do this? Did you read their full blood count? Give me a number! Did you look at your patient? What symptoms do they have? You have their Full Blood Count…..

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The Practicalities of Blood Transfusion

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  1. The Practicalities of Blood Transfusion

  2. You’ve Identified An Anaemic Patient (Well done you………..) • How did you do this? Did you read their full blood count? Give me a number! Did you look at your patient? What symptoms do they have? • You have their Full Blood Count….. What else can this tell you about the anaemia? • How are you going to treat your patient? Do you need to treat your patient? When? How?

  3. But first: The 1 thing to remember………. Do HAEMATINICS • Folate • Ferritin • Vitamin B12 before you transfuse………. Why?

  4. Transfusions • ALWAYS ask: Do I need to be doing this? (The one time you can be a lazy doctor). Transfusion is a HIGH RISK procedure. • Think twice EVERY time you transfuse- especially if: you have a young, female, transfusion naïve, stable patient and it’s OOHs. • Consider other causes/options: iron replacement, B12, folate, EPO, autologous transfusion • Transfuse the patient who is compromised and whose life is threatened

  5. How do I transfuse? • Take the xmatch samples and label them yourself, handwrite the bottle • You will be told you need a large canula-this is not always the case If the blood needs to be fast, it definitely helps, but blood can go through a blue with a good firm grip on the bag to help it along Make sure you have access before the bloodbag arrives! • Prescribe: 1 unit Red Cells over 3-4 hours IV (prescribe each bag separately) Speed up if necessary (2 hourly) don’t go slower than 4 • Followed by IV Furosemide: 20mg iv after each bag • When your blood is ready the ward will be informed, the staff will collect it and do the checks themselves Unless there’s an issue, you probably won’t be involved again

  6. Take home messages: • Identify the cause of anaemia • Haematinics • Haematinics • Haematinics • Question the transfusion

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