Crossmatched blood
Crossmatched blood is held in the Issue Fridge in Pathology at the respective sites. The blood bank register must be signed for all units collected from the Issue Fridge. Personnel collecting blood components must bring with them blood collection slips. At PRH these are filled in by the ward staff or porters. At RSCH the porters fill in the details.
The collection slips must have the details of the patient for whom the blood component is required. The collection slips are returned to the ward and a nurse must sign that the unit of blood has been received on the ward. Crossmatched blood is reserved for 24 hours, from the date required.
Traceability slips
These must be completed and returned to the respective transfusion laboratory immediately after transfusion. The EU blood Directive states that their must be vein to vein traceability of blood and blood products. Failure to complete and return the traceability slips is in breach of the EU Directive.
Blood storage
Blood must be kept at 2-6°C in designated blood fridges. Under no circumstances must it be stored in domestic fridges. Blood that has been out of the blood fridge for more than 30 minutes with no imminent prospect of transfusion must be returned to the laboratory for disposal. Blood returned within 30 minutes must be placed in the blood fridge and the blood bank register completed with the time and date of return and the signature of the person returning it. Laboratory staff must be made aware of out of temperature-controlled units of blood.
Information on red cell administration.
Fresh frozen plasma
Stored frozen at -30°C, and must be thawed by laboratory staff prior to issue. Blood group of patient must be known. Thawing takes approximately 30 minutes. Once thawed and removed from the issue fridge the FFP must be used within 4 hours. Paediatric product also available. Methylene blue-treated plasma is available from all patients born after 01/01/1996. The Rh status of FFP is no longer relevant. FFP will be issued regardless of a patient's Rh status.
Information on FFP administration.
Cryoprecipitate
In line with the EU Directive cryoprecipitate now comes in pooled packs of 5. 1 pooled pack is equal to 5 single packs. Stored frozen at -30°C, and must be thawed prior to issue. Blood group of patient must be known. Usual dose is 2 pools. Discuss with senior member of staff and/or consultant haematologist before use. Once thawed must be used within 4 hours. The Rh status is not relevant when issuing cryoprecipitate to a patient.
Information on cryoprecipitate administration.
Platelets
4 adult packs platelets held at RSCH.
Stocks not held on PRH site. Ordered by laboratory staff from the National Blood Service and transported to RSCH/PRH. Blood group of patient must be known. Allow at least three hours. Once received, requires controlled agitation at room temperature until required. Under no circumstances are platelets to be placed in the blood fridge.
Information on platelets administration.
Human albumin solution
Available from Pharmacy Department.
Anti-D immunoglobulin
There are two doses of IgG Anti D: 500iu and 1500iu.
500iu IgG Anti D is administered to Rh D Negative women who have had any of the following potentially sensitising events after 12 weeks gestation: delivery of an Rh D positive infant, abortion, threatened miscarriage, APH, ectopic pregnancy, invasive prenatal diagnosis, intrauterine procedures, or abdominal trauma. For any of the above occurring after 20 weeks gestation a Kleihauer test must also be requested. IgG Anti D MUST be given within 72 hours of the potentially sensitising event.
1500iu IgG Anti D prophylaxis is given at or around 28 weeks.
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From the 1st June 2010 all Rh D Negative women will be given one dose of 1500iu immunoglobulin Anti D at or around 28 weeks gestation. This will replace the two doses immunoglobulin of 500iu Anti D previously given at 28 and 34 weeks gestation. |
All requests for Anti D Immunoglobulin are available on a named patient basis.
Factor concentrates
Factor VIII, Factor IX, Octaplex and Factor VIIa are available after discussion with the consultant haematologist.
Information on factor concentrates administration.
Further information can be obtained from the BSUH NHS Trust Blood Transfusion Policy.