Download Blood Components Independent Double Checks Chris Downey RN

Blood Components
Independent Double Checks
Chris Downey RN CPN(C) MSc RNFA
Blood Components
Independent Double Checks

What are classed as blood components?
 Autologous whole blood (lifespan of 35
days)
 Red blood cells (RBCs or packed cells)
 Frozen plasma (FFPs)
 Cryoprecipitate (Factor VIII)
 Platelets
Blood Components
Independent Double Checks

Blood products are never stored in a regular fridge
Brought into the room in a cooler with cool paks
Bacterial proliferation &/or loss of function in blood
components

2 blood fridges in the OR, one in Connell anesthesia
room and one in Kidd core
Where there is a definite need, Type and Cross
Where there is a potential need, Type and Hold
(KGH Blood Schedule)
Blood Components
Independent Double Checks

Why Independent Double Checks?

Literature on blood administration states:




Errors of commission 1 in 1000
Errors of ommission 1 in 100
Errors in high stress environments with rapidly occuring
events 1 in 4
Serious Hazards of Transfusion reports (SHOT)
demonstrate cases of incorrect transfusion often result
from a sequence of errors involving failure to detect the
incorrect identity of the patient &/or the blood component.
Blood Components
Independent Double Checks
 Policies
controlling Blood
Administration (Adult & Peds, not Neonates)

Intranet > KGH Community > Admin
Policy Manual




06-040
13-010
20-020
20-025
Consent for Blood Administration
Patient Identification
Administration of Blood Products
Administration of Plasma Derivatives
Blood Components
Independent Double Checks
 According
to Policy
Prior to infusing RBC’s 2 practitioners (RN, RT, Docs,
Perfusionists) will perform independent double checks
- Exception: In an emergency situation where the
practitioner is of the opinion that the time to do a
double check would put the patient at risk of serious
harm.

Blood Components
Independent Double Checks
 Documentation



All blood products have a removable label that may
be attached to the “Blood Components/Products
Transfusion Record” (pink sheet-SAP # 278 )
In the OR, when blood has been checked, Nurses will
put initials on the removal label
Do not put initials on the bag or the CBS label
(bag cannot be reused by blood services)
Blood Components
Independent Double Checks
B79269
Blood Components
Independent Double Checks
Patient Name
Blood Unit #
Blood band #
Compatibility
Blood Components
Independent Double Checks
B79269
Patient Name
Blood band #
Blood Components
Independent Double Checks
B79269
B79269
Blood Unit #
Compatibility
ABO Rh
Blood band #
Blood Components
Independent Double Checks
If any part of the check is not correct:
DO NOT TRANSFUSE
Determine if the case should proceed if the
appropriate amount of blood is not available;
Identify to team members that there is a discrepancy,
repeat the check; and
If discrepancy still exists give unit(s) to the
Perioperative RN and call Blood Bank (4188) stating
the discrepancy.
(…You may want to ask Blood Bank if they require more serum or are
they able to retype and cross with what they have)