Patient Preparation

Prior to Transfusion
Prior to Mis-O-GRAMing for blood release, take and record the patient's blood pressure, pulse and temperature. If a patient is febrile, consider postponing blood transfusion. The fever may complicate the recognition of a febrile reaction to the blood itself.

MIS-O-GRAM the request for blood release only after adequate venous access is established.

Verify the patient's identification information on the blood unit with the information on the recipient's wristband. This clerical check must be performed by two qualified health professionals trained in blood administration procedures. If the patient is alert, ask him/her to state his/her name.

Two qualified health professionals must verify that the Typenex bracelet matches the information on the patient wristband and the blood unit. Make sure the Typenex number on the bracelet matches that on the blood unit. Proper patient and unit identification is one of the most important steps in the transfusion process. If any discrepancy is noted, notify the DTM at once and return the blood product until the discrepancy is resolved.

Document the names of the two individuals performing the clerical check in the MIS chart. Also record the name of the person beginning the transfusion. This person must be certified in blood administration.

Immediately prior to transfusion, mix the blood component by gentle inversion.

Normal saline and PlasmalyteTM are the only IV solutions considered compatible with blood components.

During Transfusion
Observe the patient closely during the first 30 minutes of the transfusion.

Infuse the product slowly (e.g., 2 mL/min)

Repeat vital signs 15 minutes after the transfusion is initiated and at the completion of the transfusion.

Monitor the patient for signs of fever, chills, lumbar pain, dyspnea,urticaria, pruritus, joint pain, nausea, vomiting, hemoglobinuria, anuria or bleeding.

If any of the symptoms occur, follow the instructions under Adverse Reactions.

In all cases of suspected reaction, temporarily terminate the infusion and keep the IV line open with normal saline until the nature of the reaction is determined.

Promptly notify DTM staff in all cases of suspected transfusion reactions
(301 496-8335 or 301 496-3608).

If a unit of blood or a blood component cannot be immediately transfused it must be returned to the Blood Issue area within 30 minutes of issue to avoid wasting the product. If the blood or blood component has been entered on the nursing unit and is unable to be completely infused, return it to the DTM for disposal.

Following the completion of the transfusion, chart the required information into MIS (see MIS instructions).

.