Transfusion of blood and blood products
Blood transfusion involves giving blood or components of blood from one (the donor) to another person (the recipient). Examples of blood products include red cell concentrate, platelet concentrate and fresh frozen plasma.
For the majority of women during childbirth, a blood transfusion is never necessary. There are, however, a small number who may require it either due to severe anaemia or where there has been a significant loss of blood due to medical or obstetrical complications.
It can be a life-saving procedure but is not without its risks. Recipients rarely develop transfusion-transmitted infection or immunological sequelae such as red cell alloimmunisation. The major risk is of receiving an incorrect blood component. It is therefore paramount that local transfusion policy and procedures are strictly adhered to at all times, even in an emergency.
The decision to transfuse is made by an obstetrician and/or anaesthetist based on the situation and haematological blood values. Once that decision has been made, a number of subsequent considerations should follow.
Positive patient identification: This is essential at all stages of the blood transfusion process.
Patient core identifiers are: last name, first name, date of birth, unique identification number.
Whenever possible ask the woman to state their full name, date of birth and confirm the Unique Patient Identification number in full on their ID wristband.
Where possible, women should have the risks, benefits and alternatives to transfusion explained in a timely and understandable manner.
Pretransfusion documentation: The minimum dataset to be recorded in clinical records should contain the reason for transfusion (clinical and laboratory data), details of the information provided to the woman (risks, benefits and alternatives to transfusion) and consent to proceed.
The prescription: This must contain the woman’s core identifiers and must, as a minimum, specify what components are to be transfused, date of transfusion, the volume/number of units to be transfused, the rate of transfusion and any other special instructions or requirements, such as irradiated.