policy for blood component and blood product administration

7/31/2019 Policy for Blood Component and Blood Product Administration

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POLICY FOR

BLOOD COMPONENT AND BLOOD PRODUCTADMINISTRATION


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Coordinating Program

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Version Number: 2 Page 2 of 15

Effective Date: 2008-10-01

POLICY FORBLOOD COMPONENT AND BLOOD PRODUCT

ADMINISTRATION

TABLE OF CONTENTS

Section I. POLICY STATEMENT ...........................................................................................................

Section II. DEFINITIONS ..........................................................................................................................

Section III. GENERAL.................................................................................................................................

Section IV. ORDERING BLOOD COMPONENTS AND BLOOD PRODUCTS..................................

Section V. IDENTIFICATION...................................................................................................................

Section VI. ADMINISTRATION OF BLOOD COMPONENTS AND BLOOD PRODUCTS.............

Section 6.01 IV ACCESS, ADMINISTRATION SETS and COMPATIBLE SOLUTIONS.................Section 6.02 TRANSFUSION OF BLOOD COMPONENTS AND BLOOD PRODUCTS..................

Section 6.03 POST ADMINISTRATION...............................................................................................

Section VII. DOCUMENTATION................................................................................................................

Section VIII. REFERENCES ..........................................................................................................................

Section IX. APPENDICES ...........................................................................................................................APPENDIX 1: ABO & Rh Compatibility Table .............................................................................................

APPENDIX 2: ALGORITHM FOR SUSPECTED TRANSFUSION REACTIONS......................................

APPENDIX 3: SUSPECTED TRANSFUSION REACTIONS SIGNS AND SYMPTOMS........................

APPENDIX 4: RECORD RETENTION REQUIREMENTS ..........................................................................


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Section I. POLICY STATEMENT

The Policy of the Regional Health Authorities is to ensure that blood components and blood products are

transfused to patients for clinically appropriate conditions with a goal to optimize patient outcomes and ensure

blood components and blood products are used appropriately according to established standards

Section II. DEFINITIONS

Blood Component: a therapeutic part of blood intended for transfusion

Blood Product: therapeutic product derived from human blood or plasma and produced by a manufacturing

process.

Compatibility Label / Tag: tag or label attached to a blood component or blood product that has been designatedfor a specific recipient, specifying information that identifies the blood component or blood product for thatrecipient.

Transfusionist: individual who administers a blood transfusion.

Vital Signs: the measurement of temperature, pulse, respiration rate and blood pressure.

Whole Blood: unaltered anticoagulated blood collected from a donor.

Shall: Implies that the standard is mandatory. Noncompliance means that the transfusion service is not meeting

the current acceptable expectations for the practice of transfusion medicine

Should: Implies that the standard is recommended but is not mandatory for the transfusion service.

May: Implies that the standard is considered valid but is used at the discretion of the transfusion service medical

director and / or the technical supervisor.

Section III. GENERAL

1. Informed Consent: An informed consent policy shall be established to ensure patients are properly informedbefore receiving blood components and blood products. The recipient shall receive information that includes

a description of the blood components or blood products, the associated risks and benefits as well asalternatives to transfusion if appropriate. The policy shall identify the process of obtaining recipient informed

consent including the opportunity to ask questions and obtain satisfactory answers. All recipients shall benotified in writing that they have received blood components and blood products.

2. The Transfusion service shall establish a transfusion committee with documented terms of reference. Thecommittee shall meet at least quarterly. The transfusion committee may serve more than one facility within a

region.


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ADMINISTRATION

3. Policies and procedures shall be established for:3.1. preparation and receipt of requests for transfusion3.2. unequivocal identification of recipient3.3. collection and labeling of recipient blood specimens3.4. record checks3.5. pretransfusion testing.

4. A policy shall be established for transfusions in special circumstances that include:4.1. Massive transfusion4.2. Emergency transfusion4.3. Infants under 4 months

5. Each facility shall have policies and procedures for:5.1. The transfusion and administration of blood components and blood products and the generation and

maintenance of transfusion records.5.2. The operation of infusion devices and associated equipment

Section IV. ORDERING BLOOD COMPONENTS AND BLOOD PRODUCTS

1. The Physician shall ensure the following is legibly documented when prescribing blood components andblood products:

1.1. Written consent for transfusion1.2. Patient refusal to transfusion.1.3. Patients first and last name and identification number on the order request1.4. Clinical indication for transfusion1.5. Date and time of the transfusion, rate of infusion or duration of the transfusion1.6. Type and quantity of blood product including specific product requirements or modifications (e.g. CMV

neg or irradiated products or washed)

1.7. Requirement for the use of blood warmers or rapid infusion device, except in identified clinical areaswhere there is an established hospital policy and procedure

1.8. Indication for the use of serologically incompatible blood when compatible blood is unavailable1.9. Indication for the use of unmatched blood in life threatening situations.1.10 Pre / post transfusion medication orders related to transfusion

2. The transfusionists responsibility shall include:2.1. Confirmation that the physicians order accurately identifies the patient name, identification number,

blood component or blood product, rate of infusion, date and time and all other items listed in Section

IV.1.2.2. Confirmation that the patient consent to transfusion has been signed.2.3. Completion of the requisition for request to provide blood components and blood products

Section V. IDENTIFICATION

1. Policies shall be established that ensure unequivocal identification of the recipient and the bloodcomponent or blood product throughout the transfusion.


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Section VI. ADMINISTRATION OF BLOOD COMPONENTS AND BLOOD PRODUCTS

Section 6.01 IV ACCESS, ADMINISTRATION SETS and COMPATIBLE SOLUTIONS

1. Whole blood and blood components shall be transfused using sterile, pyrogen free administration setscontaining a filter.(i.e. Adults: 170-260 microns. Pediatrics: Reference should be made to hospital policy and

procedure. For blood products the transfusionist should refer to the product monograph for filter size where

applicable.

2. Blood administration sets should be connected directly to the IV access site. Blood components shall not bepiggy-backed into an existing line as it increases the risk of contamination and /or infusion of an incompatible

IV fluid.

3. Blood component administration should begin within 30 minutes from the time the product is released fromtemperature controlled storage and shall not exceed four hours from the time of issue from temperaturecontrolled storage.

4. Blood components and blood products shall be returned to the Transfusion Laboratory immediately if adecision is made not to transfuse.

5. Blood components that have been out of temperature controlled storage greater than 30 minutes shall not bereturned to inventory or re-issued and shall be discarded by the Transfusion laboratory.

6. Blood products may be returned to the Transfusion Service where policies exist.7. Administration sets shall be changed after four consecutive units of red cells have been transfused or if the set

becomes occluded. The set shall be changed at least once every 24 hours or according to manufacturers

requirements.

8. Administration sets shall be changed between the administration of different blood components and bloodproducts. Platelets should always be administered using a new blood administration set to prevent plateletsfrom becoming trapped in the used filter.

9. Only Health Canada approved infusion devices and ancillary equipment shall be used. Infusion pumps shallbe used as recommended by the manufacturer. The pressure exerted by pressure pumps should not exceed

300mm Hg. Rapid infusion devices shall be used only by appropriately trained staff.

10. Blood warming devices shall be validated and have a temperature sensing device and an audible alarmsystem.

11. Medication shall not be added directly to a blood component or blood product nor to the administration setcontaining a blood component or blood product.

12. 0.9% sodium chloride solution for IV use may be added to red blood cells on the request of the physician or ifthe administration set requires priming for blood components.

NOTE: 5% dextrose in water will cause clumping and/or hemolysis of red cells

5% dextrose in 0.2% saline causes red cell agglutination at room temperature

Lactated Ringers may cause clotting due to calcium content.


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EXCEPTION: Intravenous Immune Globulin (IVIG)

5% dextrose in water (D5W) shall be used when administering IVIG. 0.9% sodium chloride is NOTcompatible with IVIG.

13. Air shall not be introduced into the administration set or the blood components or blood products beingtransfused.

14. Blood components and blood products shall be visually inspected for clots, clumps or discolorationimmediately before issue and the inspection documented. The expiry date shall be checked to ensure the

blood component or blood product is not outdated.

15. Blood components and blood products (specifically red cells, platelets and cryoprecipitate) shall be mixedgently by inversion to resuspend product.

16. Transfusion flow rates should be indicated on the physicians order. If possible, transfusions should startslowly and the patient observed for the first 15 minutes for any adverse effects of transfusion.

Section 6.02 TRANSFUSION OF BLOOD COMPONENTS AND BLOOD PRODUCTS

1. Pre-transfusion vital signs shall be monitored and documented prior to transfusion of all blood componentsand blood products. These include temperature, pulse, respiration rate and blood pressure.

2. The compatibility / label tag shall remain attached to the blood component or blood product until thetransfusion is complete.

3. Immediately prior to transfusion in the presence of the patient, confirmation and documentation of identifyinginformation linking the recipient and the blood component or blood product shall be performed by theTransfusionist

4. If a discrepancy is identified, transfusion shall not be initiated until the discrepancy is resolved.5. There shall be an identical match between the patient and the blood components or blood products and the

compatibility label /tag for the following with the exceptions noted in Appendix 1- ABO & Rh CompatibilityTable:

Patient Name and identification number shall match on:o Admission/Discharge Sheet (i.e. Patients medical chart / record)o Compatibility / label tag attached to blood component or blood producto Patients armbando

If patient is conscious, the patient should be requested to state their full name.Blood group and Rh of both the patient and blood component or blood product shall match on the:o Compatibility / label tag attached to blood component or blood producto Patient blood group and Rh or crossmatch report on the medical chart / recordo Canadian Blood Services blood component label

Unit number / Lot number blood component or blood product shall match on the:o Compatibility / label tag attached to blood component or blood producto Patient blood group and Rh or crossmatch report on the medical chart / recordo Canadian Blood Services blood component label


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Confirm that the blood component or blood product has not expiredNOTE: DO NOT START the transfusion if there is not an identical match. Notify the BloodTransfusion Laboratory. (See Appendix 1: ABO Compatibility Table)

6. The patient should be informed of the purpose of the transfusion and instructed to notify the nurse if any ofthe following complications occur: chills, shakes, hives or itching, difficulty breathing, backache, pain.

7. Date and start time of transfusion shall be documented.8. Recipient vital signs shall be monitored and documented before the transfusion begins, within the first 15

minutes of starting the transfusion, every hour during the transfusion and 30 minutes after completion of the

transfusion.

9.

The transfusionist shall assess the patient during the transfusion for signs and symptoms of adversetransfusion reactions that include but are not limited to: fever, chills, shakes, hives or itching, difficulty

breathing, backache, pain. (See Appendix 2: Algorithm for Suspected Transfusion Reactions)

10. IF ANY ADVERSE TRANSFUSION REACTIONS ARE OBSERVED: THE TRANSFUSION SHALL BE STOPPED IMMEDIATLEYby clamping the tubing as close to the

IV site as possible. Any remaining blood component or blood product in the tubing should not be

flushed.

Lines should be kept open with 0.9% Sodium Chloride. The name of patient and identification number on the patient armband shall be confirmed against the

compatibility / label tag and documented.

The physician shall be notified. Vital signs shall be rechecked and documented. The Blood Transfusion Laboratory shall be notified All observed signs and symptoms shall be documented on the patients medical chart /record, the

compatibility / label tag and if applicable the adverse transfusion reaction form

The volume transfused shall be documented on compatibility / label tag and on the patients chart Any intervention or action taken shall be documented. All blood component and blood product containers with attached administration set and IV solutions,

whether empty or not, appropriate blood samples and documentation shall be returned to the TransfusionLaboratory as soon as possible for follow-up investigation

11. Serious Adverse Transfusion Reactions shall include but are not limited to: Immediate hemolytic reactions Delayed hemolytic reactions Transfusion related acute lung injury Systemic allergic reactions including anaphylactic shock Bacterial sepsis Other transfusion transmissible infections Death Transfusion associated graft versus host disease Post transfusion purpura Other serious reactions


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(See Appendix 3: Suspected Transfusion Reactions Signs and Symptoms)

12. In the absence of an adverse transfusion reaction, the transfusion shall continue to completion.Section 6.03 POST ADMINISTRATION

1. The IV line shall be flushed following transfusion.2. The blood component or blood product and administration set shall be disconnected.3. Following completion of the transfusion, post transfusion information shall be documented on the

compatibility label/ tag and the patients chart.

4. Return the laboratory portion of the compatibility label/ tag to the Laboratory according to local procedure.5. The transfusionist shall monitor the patient for at least 30 minutes after the transfusion.6. Blood component and blood product containers shall be disposed of in compliance with universal precautions

according to hospital policy and procedure.

Section VII. DOCUMENTATION

1. The recipients medical chart /record shall contain a transfusion record that includes the followinginformation:

1.1. blood component or blood product identification number1.2. type of blood component or blood product transfused1.3. start, finish, date and time of transfusion1.4. identity of transfusionist1.5. any transfusion reactions

2. For each blood component issued, a record system shall be in place which documents:2.1. recipients name and identification number2.2. recipients ABO group2.3. recipients Rh group2.4. identification number and name of blood component2.5. ABO group of the blood component2.6. Rh group of the blood component for red cells, platelets and granulocytes2.7. compatibility verification for red cells and granulocytes2.8. visual inspection2.9.

date and time of issue2.10identity of the person issuing the blood component

2.11identity of the person transporting the blood component to the recipients location3. For each blood product issued, a record system shall be in place which documents:

3.1. recipients name and identification number3.2. blood product name and manufacturer3.3. lot number3.4. volume and /or potency


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3.5. dosage / vials issued3.6. visual inspection3.7. date and time of issue3.8. identity of the person issuing the blood product3.9. identity of the person transporting the blood product to the recipients location

4. A copy of the transfusion information related to the patient shall become part of the recipients permanentmedical chart / record.

5. The record keeping system shall be able to trace the blood component or blood product.6. Records shall be retained for the time periods stated in Appendix 4.


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Section VIII. REFERENCES

About Blood Transfusion, Information for Nurses and Other Health Care Professionals, 1st Edition,

Transfusion Ontario Program, 2004.

About Blood for Patients, Transfusion Ontario Program, 2004

Administrative Manual of Departmental Procedures, James Paton Memorial Hospital, Gander,

Newfoundland and Labrador.

American Association of Blood Banks, Technical Manual, 15th

Edition

Blood Easy 2, Blood Transfusion, Blood Alternatives and Transfusion Reactions, A Guide toTransfusion Medicine, 2nd Edition, JL Callum and PH Pinkerton, Sunnybrook and Womens College

Health Sciences Centre, 2005

Canadian Blood Services Circular of Information 2004, Canadian Blood Services

Canadian Standards Association Blood and Blood Components. (CAN/CSA-Z902-04). Mississauga,

Ontario, Canadian Standards Association, 2004.

CSTM Standards for Hospital Transfusion Service, Version 2, Canadian Society for Transfusion

Medicine, 2007.

Canadian Transfusion Adverse Event Reporting Form, Users Manual, Version 3, Public Health Agency

of Canada

Guidelines for red blood cell and plasma transfusion for adults and children. Expert Working Group,

Canadian Medical Association, Canadian Medical Association Journal, June 1, 1997, Special Supplement

Guidelines for Red Blood Cell Transfusion, British Columbia Transfusion Medicine Advisory Group,

November 2003.

Guidelines for Platelet Transfusion, Y.Lin, L. Foltz and the British Columbia Transfusion Medicine

Advisory Group, November 2003.

Guidelines for Substitution of Blood Components for Adult Patients During an Inventory Shortage,

Transfusion Medicine Advisory Group / CBS BC & Yukon, March 2003.

Guideline for Investigation of Suspected Transfusion Related Bacterial Contamination, Transfusion

Transmitted Injuries Section, Public Health Agency of Canada, October 2007, http://www.phac-

aspc.gc.ca/publicat/ccdr-rmtc/08pdf/34S1-eng.pdf

Manitoba Transfusion Quality Manual for Blood Banks, Version 2, June 2007, Manitoba Provincial

Blood Programs Coordinating Office, Winnipeg, Manitoba.


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Manitoba Transfusion Medicine Best Practice Resource Manual for Nursing, Version 1, June 2007,

Manitoba Provincial Blood Programs Coordinating Office, Winnipeg, Manitoba

Nova Scotia Provincial Blood Coordinating Program, Nursing Policy and Procedure for Blood,

Blood Component and Plasma Derivative Administration, Rev 01/06, Nova Scotia Provincial Blood

Coordinating Program.


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Section IX. APPENDICES

APPENDIX 1: ABO & Rh Compatibility Table

ABO & RH COMPATIBILITY TABLE

Patients ABO & Rh Donor Blood Component Compatibility

Packed Red Cells1

Plasma Products2,3

O Pos O Pos, O Neg

O Neg O NegAll groups

A Pos A Pos. A Neg,

O Pos, O Neg

A Neg A Neg, O Neg

A, AB

B Pos B Pos, B Neg,

O Pos, O Neg

B Neg B Neg, O Neg

B, AB

AB Pos All Groups

AB Neg AB Neg, B Neg,

A Neg, O Neg

Only AB

1Rh negative recipients should be transfused with Rh negative red cells. A policy shall

be in place for the administration of Rh positive red cells to any Rh negative recipient

when Rh negative red cells are in diminished supply.

2Rh is not considered when transfusing plasma components.

3When Rh Positive platelets are given to an Rh negative patient, Rh Immune Globulin

should be administered.


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APPENDIX 2: ALGORITHM FOR SUSPECTED TRANSFUSION REACTIONS

Patient Exhibits Signs and Symptoms of a Transfusion Reaction

1.STOP TRANSFUSION IMMEDIATELY and keep IV line open with 0.9% saline.2.Contact physician for medical assessment.3.Check vital signs every 15 minutes until stable.4.Check all labels, tags, forms, blood order and patients identification band to determine if there is a clerical

discrepancy.

5.Notify Blood Transfusion Laboratory

Note: Patients who are transfused for the first time may have a more serious transfusion reaction.

Allergic Reaction? Febrile Reaction?

Skin Reaction ONLY AND MildHives/rash 25% body

(no other symptoms)

Temp $38C or change of$10 C from

pretransfusion value

AND No other symptoms

AND Onset > 15 minutes into transfusio

- Physician may orderDiphenhydramine 25-50mg IV orPO

- Resume transfusion slowly &cautiously, complete within 4 hours

of issue

- Physician may order Acetominophen600mg PO or PR

- Initiate Transfusion reaction form- Send samples to Blood Transfusion

Laboratory (BTL) for appropriate testi

- If serological testing is negative, resumthe transfusion slowly and cautiously,complete within 4 hours of issue

Minor Allergic Minor Febrile Non-Hemolyt

IF Patient HAS ANY ONE OR MORE OF THE FOLLOWING

SYMPTOMS DURING Transfusion:

-Temperature$380C or change of$1C from pretransfusion value- Onset < 15 minutes -Hypotension / shock- Rigors - Anxiety- Back / chest pain -Nausea / Vomiting- Dyspnea / SOB -Hemoglobinuria-Bleeding/pain at IV site -Tachycardia / arrythmias- Generalized flushing - Hives/rash $25% body

DO NOT RESTART TRANSFUSION

-Notify Physician immediately

-Notify Blood Transfusion Laboratory (BTL)

-Send to the BTL:- Appropriate post transfusion blood & urine samples- Completed Compatibility Label / Tag- Remaining Blood component or blood product and administration

set/fluid

Consider:

- Blood and product cultures if patient temperature is $380C- Chest X-Ray for severe Dyspnea

Consider Serious Transfusion Reactions:

- Serious Febrile Non-Hemolytic - Acute Hemolytic- Severe Allergic - Anaphylactic

- Bacterial Contamination- Transfusion Related Acute Lung Injury (TRALI) or Possible TRALI

- Transfusion Associated Circulatory Overload (TACO)

- Transfusion Associated Dyspnea (TAD)

Serious Signs & Symptoms? Clerical Discrepancy? Minor Symptoms?

If remainder of

transfusion isuneventful, bloodspecimens are not

required

- Initiate Transfusionreaction form

- Observe patient

directly for first 15

min after resuming

transfusion.

- IMMEDIATELYSTOP the transfusion

if patient develops anySERIOUS SIGNS and

SYMPTOMS.

- Follow the serious

signs and symptoms

pathway

It remainder of transfusio

is uneventful,- Send the blood componor blood product and bloo

administration set to Bloo

Transfusion Laboratory

Production of this document has been made possible through a financial contribution from Health Canada. Ver. 2, 2008-06-30


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APPENDIX 3: SUSPECTED TRANSFUSION REACTIONS SIGNS AND SYMPTOMS

Type of Reaction Suspected Transfusion Reaction Signs

& Symptoms

Timing of Symptoms Actions & Suggested Treatment /

Investigations

ACUTE ( < 24 hours)Minor Allergic

Reaction

Pruritis, mild rash, urticaria, flushing During transfusion up to

2-3 hours from start

Consult with Physician Antihistamine

and proceed with caution

Febrile Non-Hemolytic Temperature increase 38C or 10C from

pre-transfusion value, chills, rigors, headache,

malaise, vomiting, nausea

During transfusion,

usually towards the end

or when the transfusion

is completed

Consult with Physician Antipyretic

Acute Hemolytic(AHTR)

Temperature $390C, chills, rigors,fever,

hemoglobinuria, less common: renal failure,

hypotension and/or tachycardia, DIC, oliguria,

oozing from IV site, back pain, pain alonginfusion site

Usually within first 15minutes but may be later

DO NOT RESTART TRANSFUSIONMonitor for hypotension, renal failure and

DIC

Treatment aimed at preventing renalfailure

Transfusion Associated

Circulatory Overload

(TACO)

Dyspnea, orthopnea, productive cough with

pink frothy sputum, cyanosis, tachycardia,

hypertension, headache

Within several hours of

transfusion


Diuretics, Oxygen, Elevate head of bed

Chest x-ray

Severe Allergic /

Anaphylactic

Urticaria, erythema, anxiety, respiratory

distress, hypotension, laryngeal/pharyngeal

edema, bronchospasm, nausea, vomiting,dyspnea, cyanosis, tachycardia, substernal pain,

loss of consciousness, cardiac arrythmia,

cardiac arrest

Severe Allergic within 2-

3 hours of start of

transfusion.Anaphylactic: Usually

early in transfusion ( 1-

45 minutes) after smallvolume of product

transfused


Epinephrine, corticosteroids,

antihistamines, vasopressors

Test for Anti IgA Antibodies. Patient may

require IgA deficient blood components

Transfusion RelatedAcute Lung Injury

(TRALI)

Acute respiratory, hypoxemia, chills, fever,cyanosis, hypotension, tachycardia, bilateral

pulmonary edema

Within 1-2 hours duringtransfusion or within 6

hours post-transfusion

DO NOT RESTART TRANSFUSIONOxygen, intubation and ventilation,

vasopressors, chest X-ray

Transfusion AssoicatedDyspnea (TAD)

Respiratory distress within 24 hrs oftransfusion that does not meet the criteria of

TRALI, TACO or allergic reaction.

Respiratory distress not explained by patientsunderlying condition

Within 24 hours oftransfusion

Consult with PhysicianAssess symptoms , consider other types of

transfusion reactions if circulatory

overload is not the cause of the dyspneaOxygen and supportive care as required

Hypotensive Flushing, abrupt onset of hypotension with or

without bradycardia, nausea, dyspnea, urticaria

Within 5 minutes after

beginning of transfusion


Administer saline bolus, vaopressorsWithdraw ACE inhibitor therapy 24-48

hours prior to next transfusion

Bacterial

Contamination

Fever, shock, DIC, nausea, vomiting,

tachycardia, hypotension, chills, rigors, SOB,

circulatory collapse

Within 4 hours of

transfusion


Treatment of shock, DIC, renal failure

Administer antibiotics, perform bloodculture

DELAYED (>24 HOURS)Delayed Hemolytic Weakness, unexplained fall in post-transfusion

hemoglobin, elevated serum bilirubin, fever,

weakness, malaise

Within 3-7 days post-

transfusion and up to 21

days post-transfusion

Provide antigen negative blood

components for future transfusions

Transfusion Associated

Graft Versus HostDisease(TA-GVHD)

Erythroderma, maculopapular erythematous

rash, nausea, anorexia, vomiting, diarrhea,hepatitis, pancytopenia, fever, jaundice,elevated liver enzymes

Fever within 7-10 days

of transfusion

Immunosuppressive therapy, Irradiated

products. Most patients die within 1-3weeksPrevention: Transfuse patient with

irradiated red blood cells and platelets

Post Transfusion

Purpura (PTP)

Purpura, petechiae, bleeding, fall in platelet

count to


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APPENDIX 4: RECORD RETENTION REQUIREMENTS

MINIMUM RETENTION PERIOD TYPES OF RECORDS

Indefinitely

Blood component and blood product final disposition

Blood supplier correspondence related to blood components andblood products

Blood supplier packing slips

Directed Donor charts

Donor ABO and Rh Groups

Donor testing worksheets and results

Lookback and traceback documents

Serious adverse reactions

Transfusion recipients transfusion service (blood bank) data including

serologic test records

Transfusion records in recipient medical chart / recordTransfusion service packing slips

10 years Donor ABO, RH and blood group determination problemsEmployee signature, initials, computer identification (retained for 10years after last use)

Staff qualification, training, competency (retained for 10 years after

employment ceases)

5 years Adverse reactionsAutologous donor charts

Blood component and blood product complaintsInspection of blood prior to use

Internal audits

Proficiency testing reports

Quality assurance reportsQuality control of blood components and blood products reagents and

equipment

Temperature monitoring of blood storage devices

3 years Non-transfusion serologic test recordsValidation and operation of computer systems

1 year Date and time of specimen collectionPhlebotomists identification

3 months Slides from fetal-maternal hemorrhageRecords of units phenotyping and ABO reconfirmation of units

1 month Request for serologic tests

policy for blood component and blood product administration

Documents