What House Officer Needs to Take Note?
GSH
GSH is valid for 48 hours most of the time. Different blood banks might have different policy on GSH and GXM.
When requesting for blood / blood products
Urgency
☀️ Need to be clear about the urgency: Not every blood transfusion is urgent, ‘urgent’ means blood must be available in less than 2 hours & the blood cannot be fully crossmatched. Otherwise, ‘non-urgent’ means can wait for 2 hours or more for blood to be fully crossmatched at blood bank.
☀️ Why urgent? Is your patient having active / massive bleeding?
☀️ Clarify the urgency with your MO if you are not sure.
Prior to transfusion
- It’s recommended to check blood JUST BEFORE transfusion
- CHECK the relevant checklist/transfusion request forms (GSH form) / blood bag / case notes/patient to confirm the identity. Check at bedside (in front of patient), by 2 staff (a doctor & a nurse)
During Transfusion
Look for signs / symptoms of transfusion reaction, which usually occur during first 30 minutes of transfusion
If 2 pints packed cells are being transfused, IV Frusemide (e.g. 20 mg) stat can be considered in between transfusion, to prevent fluid overload (confirm with MO first)
Post Transfusion
Repeat FBC 6H post transfusion
Near Miss & Transfusion Error
Examples of transfusion error
- Transfusion of ABO compatible blood but to a wrong patient
- Transfusion of incompatible blood to a patient