Understanding Blood Transfusion: The Importance of Pre-assessment and Compatibility, Exercises of Theatre

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Why one size does NOT fit all

Presentation by: Nicola Main Date: 24 September 2013

All of the information in this presentation is based on my own experience and knowledge. Other hospitals may have policies based on local risk assessments and requirements. CHS 970 beds 40000 Group & Saves 10,000 units per year

Chief / Senior chief Band 8a and above Senior Specialist Biomedical Scientist Band 7 Biomedical Scientists & Specialist BMS Band 5 & 6. Pathology Support Worker (PSW) / Medical Laboratory Assistant (MLA) / Assistant Technical Officer (ATO) / Associate Practitioner (AP) Band 1- TP or SPOT Band 6 or 7

Group & Save, Group & Screen, Type & Screen, Serum Hold, Screen & Hold, Group & Hold They are all the whole blood sample (taken into EDTA tube) which is hand written with 4 points of reference, from which blood may be cross-matched.

Anyone who may need blood Depends on procedure Anyone who may need a blood product Underlying condition Preventative measure (e.g. prophylactic anti-D) Once the at-risk groups have been identified they should ALWAYShave a G&Staken.

Sample validity Antibody status Crossmatching units Available blood WBIT s

Current Blood Product User guide states: Pre-operative Group & Save samples are used for antibody screen only, and a further group &save sample is required on admission if blood is required for theatre.

Has been in use at SRH for years. Applies even if sample taken in last 7 days.

Processed in non-urgent manner. Group recorded in patient history. Antibody status recorded. If negative Can use Electronic Issue if positive: Investigate comment added to sample to request G&S on admission (or before). details written in diary in transfusion dept to order antigen negative units.

Blood Group Automated with Barcodes Bi-directional interface If known, check against historical then file O,A,B,AB Rh Pos or Neg

So how long for the blood? How long is a piece of string? Can we identify the antibody? Or do we have to send the sample to Reference lab? What is the antibody? Is it common or rare? Do we have antigen negative blood in or do we have to order it from NHSBT?

Only 40% of hospitals use EI. All hospitals have Surgical Blood Order Schedule. So what your hospital requires depends on The cross-matching technique employed The nature of the procedure Any underlying conditions Any antibodies detected

Need more than one group on a patient one historical + a current OR Two samples from current admission

WBIT Wrong Blood In Tube

Get the blood group wrong = could kill the patient.