Transfusion practice

The BloodSafe Program  has developed a set of resources to provide clinicians with information on recommended transfusion practices.

Consent

Consent is a process – not a piece of paper. Use a competent interpreter when the patient is not fluent in English.

Give written information and use diagrams where appropriate.

Explain to your patient:

• cause/likelihood of bleeding/low blood count (including any uncertainty)
• nature of the proposed transfusion therapy – what is involved?
• benefits expected?
• risks – common and rare but serious?
• alternatives – including the risk of doing nothing?

Ask your patient:

• is there anything else you would like to know?
• is there anything you do not understand?

Refer to your hospital/health service policy for documentation requirements and when/if consent is required.

More information

For more information about transfusion risks and information to help with informed consent, see:

• Lifeblood’s risk estimates for transfusion-transmittable infections
• Lifeblood’s relative risk of transfusion fact sheet 
• BloodSafe’s blood transfusion information fact sheets (available in 18 languages)
• BloodSafe’s paediatric transfusion information resources (select 'children and transfusion')

Prescribing of blood and blood components

Quick reference guides on red cell transfusion for:

• Medical patients (PDF 622KB)
• Surgical/perioperative patients (PDF 331KB)

When patients are transfused, a medical records sticker (PDF 104KB) needs to go into the patient's notes. These stickers prompt to help record the clinical indication for red cell transfusion.

Administration of blood and blood components

• Sunrise EMR How-to guide (PDF 340KB) — to assist with double independent checking and documentation in Sunrise EMR immediately prior to transfusion.
• Transfusion pre-administration double independent check (PDF 174KB) — a short checklist to assist with double independent checking at the patient's side immediately prior to transfusion.
• A how to video: Double Independent Check for Blood Products using Sunrise
• The Blood Book: Australian Blood Administration Handbook - A bedside resource to assist with correct transfusion administration practice.
• ANZSBT guidelines for the administration of blood components - Australian and New Zealand guidelines for the administration of blood components.
• For reporting of transfusion adverse events, use the SA Pathology form

Internationally-standardised format of donation numbers on blood packs (ISBT 128) 

Resources to support the transition to the ISBT 128 format of donation numbers on blood packs by SA Pathology to support SA Health Hospitals.

• Quick Reference Guide: Transition to ISBT 128 Donor Number for Blood Transfusion (PDF 2.7MB)

Collecting specimens

Resources to help with correct patient identification:

• Wrong blood in tube investigation and reflection tool (DOCX 414KB)

Label before you leave

• Poster for SA Health employees — Label before you leave (PDF 535KB)
• Screensaver for SA Health employees — Label before you leave (PNG 1.5MB)
• Poster for patients — Label before you leave (PDF 561KB)
• Screensaver for patients — Label before you leave (PNG 1.9MB)

Videos

• Pre-transfusion sample collection and labelling using Sunrise EMR ;video
• Ordering pathology samples and preparing for collection video
• Patient identity check and sample labelling video

Cryoprecipitate

• Cryoprecipitate Clinical Update (PDF 143KB) — provides a clinical update on Cryoprecipitate pack changes, dosing in adults and children and ordering in Sunrise EMR
• Cryoprecipitate Pack Changes - brief update — provides a brief update on Cryoprecipitate pack changes and dosing
  
• Cryoprecipitate Dosing Reference Guide (PDF 118KB) — provides reference information on Cryoprecipitate dosing including fibrinogen content and volume of different pack types

Fibrinogen Concentrate

• Fibrinogen Concentrate Ordering and Transfer — provides guidance to hospitals on the ordering and transfer processes for fibrinogen concentrate

• Reconstituting Fibrinogen Concentrate (Riastapp) — the 2 Person / 1 Bag Technique video

• Introduction of Fibrinogen Concentrate across nominated regional sites in South Australia video

Intravenous Immunoglobulin (IVIg) product administration guidelines

Administration guidelines for:

• Flebogamma 5% (PDF 51KB)
• Flebogamma 10% (PDF 51KB)
• Gamunex 10% (PDF 95KB)
• Intragam 10% (PDF 212KB)
• Kiovig 10% (PDF 51KB)
• Octagam 10% (PDF 56KB)
• Privigen and Privigen AU 10% (PDF 51KB)

Paediatric transfusion information kit

A Paediatric transfusion information kit has produced to help explain what will happen and why transfusions are needed for children. The kit is available on the Blood transfusions page, or for printed copies contact BloodSafe.

The paediatric transfusion information kit was produced collaboratively by:

• BloodSafe
• the Australian Red Cross Blood Service
• the New Zealand Blood Service
• the Australian and New Zealand Society of Blood Transfusion.

The kit was originally created by the National Health Service in the UK and has been adapted for Australia and New Zealand.