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TITLE
CLIN_092 ADMINISTRATION OF BLOOD AND BLOOD COMPONENTS
APPLICABILITY
EDWARD HOSPITAL
POLICY STATEMENT(S)
To outline a process to safely obtain and administer blood and blood components in
accordance with applicable regulatory standards.
DEFINITION(S)
ATX Number – a unique number (4 numbers and one letter) assigned to each patient who may
require blood / blood component transfusion.
Blood – whole blood or packed red blood cells (PRBC)
Blood Components – Fresh Frozen Plasma (FFP), platelets or cryoprecipitate.
PROCEDURE
A. CONSENT
1. Consent is obtained for all transfusions, including autologous, with an initial order for a
transfusion of blood or blood components. The written consent form is valid for the
entire admission unless otherwise revoked by the patient.
2. In situations where an emergency transfusion is necessary, no written consent is
required.
3. The doctor ordering the transfusion is responsible for obtaining informed consent from
the patient prior to the event. Nursing obtains documentation on the consent form.
4. If the patient refuses to consent to the transfusion, the refusal is documented in the
medical record.
5. See Exhibit A “Informed Consent to Transfusion of Blood or Blood Components.”
B. ORDERING
1. Blood/blood components are ordered through the computer system. During computer
downtime, a manual lab requisition is completed.
2. Utilize the appropriate blood transfusion focused order set (adult/pediatric/neonatal).
Follow order set prompts to order type and screen, product preparation and product
transfusion.
3. Enter the transfusion indication for each blood / blood product order.
4. Release the transfuse order and generate the blood release form from the electronic
medical record (exception: OR uses a manual blood release form).
a. Complete the form with the required information including the patient’s ATX number,
nurse spectralink number and tube station number.
b. Send the form to blood bank to requisition the product for transfusion.
c. NICU – When the product is dispensed in multiple aliquots, reorder transfuse
product using the Additional Aliquot Dispensed frequency. Release the additional
transfuse order.
C. SPECIMEN COLLECTION
1. Assign the patient an ATX number. The ATX number is placed on both the blood
sample and a green wristband on the patient by the individual who draws the blood.
2. If the patient is already wearing an ATX band call the blood bank to determine if a new
specimen is needed. If so, the ATX number must be transcribed onto the new specimen
label.
D. ISSUING/RECEIVING/RETURNING
1. The blood bank technologist issues the blood/blood component.
2. Blood or blood components are issued for only one patient at a time.
3. Transport of blood and blood components.
a. Adult/pediatric units are sent via the pneumatic tube system. NOTE: Certain
“irreplaceable” units such as autologous, designated and washed cells are
transported via a RN or designee and must be picked up from the blood bank.
b. Neonatal units are transported via a RN or designee and must be picked up from the
blood bank.
c. Surgery units
1) CVOR – units are transported via the pneumatic tube system and stored in a
Blood Bank approved refrigerator.
2) Non-CVOR – units are transported and stored in Blood Bank dispensed insulated
coolers.
4. In cases of downtime or with massive transfusion when many units are needed at once,
it is recommended to send a RN or designee to the Blood Bank.
5. The RN or designee is authorized to receive the blood/blood component from blood
bank.
6. In the event the issued blood or blood component is returned to the blood bank, it may
be accepted for reissue if returned within 30 minutes of the issue time.
a. Exception: if the unit was stored in a monitored CVOR blood refrigerator or a
container validated by the blood bank for temporary blood storage.
E. EMERGENCY RELEASE PROTOCOL
1. This protocol is used in cases where the patient’s medical condition warrants the risk of
forgoing the usual pre-transfusion testing. It is initiated by the ordering physician and
allows for the issue of units prior to completion of normally required compatibility testing.
A blood specimen is collected from the patient as soon as possible using the usual
collection and patient banding protocol (see specimen collection section). Testing of the
patient’s specimen is conducted after the fact and unusual findings are immediately
reported to the caregiver.
2. A physician or RN places an “Emergency Release” (Emergency Released Blood
Products (O neg) order in EPIC. The order provides legal documentation of the
physician’s agreement to transfuse red cell products prior to the completion of
compatibility testing. In addition, the order set automatically generates an order for a
Type and Screen test and two units of packed cells.
F. MASSIVE TRANSFUSION PROTOCOL:
1. This protocol is used in adult patients whose anticipated blood loss will exceed one
blood volume (10-12 units) in a 24 hour period. A physician or RN places an order for
“Massive Transfusion Protocol.” The order provides legal documentation of the
physician’s agreement to transfuse red cell products prior to the completion of
compatibility testing and automatically generates a Type and Screen test order. Once
initiated, the protocol will continue until the blood bank is notified of termination by the
attending physician.
2. The blood bank has primary responsibility for product order placement (in the blood
bank computer system) and preparation. Each cycle of blood product transfusion
consists of 5 red cell and 5 FFP units. With alternating cycles, 1 platelet pheresis unit
and 10 units of pooled cryoprecipitate is supplied. After each cycle is issued, the blood
bank begins to prepare the subsequent cycle. The blood bank notifies the patient care
team when the “new” cycle is ready for issue. Note that a rapid infusion device may be
utilized for massive transfusion.
3. NOTE: In the case of massive transfusion, the Blood product administration module of
EPIC is not used for the documentation of blood transfusion. Alternate documentation
methods may be used and includes evidence of positive identification of the transfusion
recipient and blood components, the identity of the transfusionist, the blood component
and unit number transfused, date and time of transfusion, evidence of patient monitoring
pre-transfusion, during and after transfusion, and any adverse effects.
G. PROCEDURE FOR BLOOD ADMINISTRATION
1. Pre-transfusion Preparation of Patient, Equipment, And Product
a. Verify physician order.
b. Explain the procedure to the patient. Discuss the anticipated length of transfusion
time, rationale for frequent vital signs and the importance of notifying an RN if
signs/symptoms of reaction occur (such as itching, chills, headache, rash, dyspnea
and chest pain).
c. Obtain consent for transfusion of blood or blood components in all non-emergent
situations. This consent identifies the risks and alternatives for transfusion of
blood/blood components. For details see Exhibit A.
d. Obtain baseline vital signs.
e. Start the adult patient’s IV with a minimum of 18 gauge IV access. Note that a
smaller gauge may be used for select patients (Exhibit B)
f. Neonates: Start the neonate’s IV with a minimum 24 gauge catheter.
g. Gather needed equipment:
1) Standard Blood Administration set: contains an integral filter and is acceptable
for use with Whole Blood, Packed Red Cells, Fresh Frozen Plasma, Platelets
and Cryoprecipitate
Neonates: Standard bore extension set
2) 0.9% normal saline (NEVER mix any medication or solutions with blood or blood
components).
3) Infusion Pump: Administer blood and blood products using an infusion pump. In
certain predetermined areas (procedural areas) and in emergent situations,
blood and blood products may be administered by gravity at the discretion of the
RN. Neonates: a syringe pump is used for the administration of blood or blood
products
4) Blood administration tubing (with integral blood filter) is changed every 4 hours or
after two units are infused, whichever comes first.
h. Prime the blood administration tubing with 0.9% normal saline and attach directly to
the patient IV
Neonates: prime the blood administration tubing with the blood or blood product.
i. Check patency of the IV before sending for blood or blood components. Infuse 0.9%
normal saline at a keep-vein-open rate.
Neonates: the peripheral IV is saline-locked unless otherwise ordered by physician.
j. Requisition product from the blood bank. See “ordering” section.
k. Upon receipt, inspect the blood or blood component for any clots, gas bubbles,
cloudiness or abnormal color. Return the blood / blood component to the blood bank
if any abnormalities are noted during visual inspection.
2. Patient Identification and Blood / Blood Component Verification
a. Verify Physician order with two registered nurses.
b. Two registered nurses and/or physicians are required to confirm the identity of the
patient and blood components directly at the bedside, unless in the operative setting
or an emergency release.
1) Open the blood product administration module and scan the patient’s wristband
when prompted. Scan the barcodes on the blood product (unit number, product
code, expiration date and blood type). Verify the information which appears in
EPIC after scanning (click accept). Note that manual entry of data is allowable if
the user enters an override reason for omitting the use of a bar code scanner.
2) If an error message appears upon scanning the product, verify that the
documentation effort was attempted using the correct product request. Contact
the blood bank for further investigation, if necessary.
3) In rare instances, it may be acceptable to administer an expired product. In these
cases, the user must choose an override reason for the transfusion of expired
product.
4) Review the following items in the blood administration flowsheet. Dual signoff
with a second RN is required.
a) unit number on the bag and on the compatibility label match
b) all patient identifiers match the compatibility label
c) the donor ABO/RH and patient ABO/Rh are compatible
d) Additional RBC match result of compatible or incompatible is noted and
entered into EPIC
e) visual inspection of the unit is completed (and unit found suitable for use)
f) ordered special processing requirement match the product label (stated
attributes)
3. Infusion Process
a. Invert the blood or blood component gently and thoroughly several times.
b. Spike the blood bag and connect to the blood administration Y set. Be certain that
the fluid level in the drip chamber covers the filter in the Y tubing.
In the NICU and in infants up to 12 months of age outside of the NICU, blood is
supplied from the Blood Bank in a prefiltered syringe. A syringe pump is used for
infusion.
c. Flow rate
Adult: Adjust the flow rate to infuse 30 ml of blood for the first 15 minutes. Observe
and monitor the patient closely for signs of transfusion reaction. In case of
hemodynamic instability, blood can be administered at a rapid rate to treat or
prevent shock.
Child: Administer blood/blood products at rate on Exhibit D. Physician may write an
order with rate if child’s condition warrants.
Neonate: Administer blood at rate ordered by physician.
d. Complete the blood administration documentation flowsheet in the electronic medical
record.
e. An RN remains with the patient during the first 15 minutes of blood product infusion.
f. Check vital signs within 15 minutes of infusion initiation and hourly thereafter until
the transfusion is completed. Document vital signs on the blood administration
documentation flowsheet.
g. If there are no signs of transfusion reaction after the first 15 minutes of the
h.
i.
j.
k.
l.
m.
n.
transfusion, adjust the rate according to the physician’s order. Four hours is the
MAXIMUM transfusion time for a unit of packed cells or whole blood.
If a transfusion reaction should occur, STOP the transfusion immediately and follow
the steps outlined in the section, “Procedure for Transfusion Reactions.”
After completion of the transfusion, flush the tubing with normal saline and obtain
vital signs.
Place the blood or blood component bag and tubing in a red bag and dispose of
them in a biohazard container on the nursing unit.
Complete the blood administration documentation flowsheet in the electronic medical
record.
Change blood administration tubing every 4 hours or after two units are infused,
whichever comes first.
Change blood administration tubing when changing the type of product to be
infused.
Do not administer different blood products through the same infusion set or the same
infusion site simultaneously. It is acceptable to infuse multiple blood products
through different infusion lines simultaneously.
4. Protocol for Handling Suspected Transfusion Reactions
a. There are a number of adverse effects of transfusion which include, but are not
limited to:
1) Immediate or delayed hemolytic reactions
2) Febrile non-hemolytic reactions (mediated by white blood cells or cytokines)
3) Urticarial reactions
4) Circulatory overload
5) Anaphylactic/anaphylactoid reactions
6) Transfusion-related acute lung injury (TRALI),
7) Transfusion transmitted disease (bacterial, viral, parasitic).
b. The Registered Nurse monitors and observes the patient for symptoms of reaction
including:
1) Temperature elevation of one degree Centigrade or two degree Fahrenheit from
pre-transfusion temperature.
2) Chills
3) Nausea and vomiting
4) Shortness of breath
5) Decrease in blood pressure
6) Shock
7) Feeling of constriction in chest
8) Severe pain in lower back
9) Change in color of urine
10) Urticaria or edema
c. If any of the above symptoms appear, take these actions:
1) Stop the transfusion immediately.
2) Obtain and record the patient’s vital signs.
3) Change the blood tubing and infuse a new bag of 0.9% normal saline at a keepvein-open rate.
4) Notify the physician to determine if the transfusion should be continued.
d. If transfusion is discontinued per physician order, take these actions:
1) Check all the identifying names and numbers on the patient’s identification band
and unit label
2) Document the transfusion reaction including patient’s symptoms and nursing
interventions related to transfusion reaction in the blood administration flowsheet
suspected transfusion reaction group.
3) Notify the blood bank of the suspected reaction.
4) Enter a Blood Transfusion Reaction order set. This will prompt the collection of a
post-reaction blood specimen for laboratory testing.
5) Send the blood / blood component bag, administration tubing and IV solutions to
the lab in a red bag. Tubing is left in place, clamped and capped with dead end
cap to prevent leakage.
5. Transporting Patients During Infusion of Blood and Blood Components
a. During transport of the patient, an RN accompanies the patient to assess and
monitor the blood transfusion.
b. The RN stays with the patient until the patient is handed off directly to another RN at
the intended destination.
c. Certain ancillary areas have RNs who may be available to monitor patients receiving
blood / blood components. Arrange for the necessary RN coverage prior to
transporting the patient.
6. Specialized Blood Components by Patient Population
a. Infants/neonates up to 12 months of age
1) All red blood cells are supplied as leukocyte-reduced and gamma-irradiated by
default. Indications for red blood cell transfusion include:
a) Symptomatic anemia with Hgb </= 10
b) Hgb </= 12 requiring ventilator support or major surgery
c) Hgb </= 13 with cyanotic or persistent pulmonary hypertension
d) Active bleeding
2) All platelets are supplied as an aliquot of a leukocyte-reduced, gamma-irradiated
single donor (apheresis) unit.
3) Red blood cell and platelet aliquots are prepared in the Blood Bank as prefiltered syringe units, with the exception of red blood cell exchange and some
intraoperative procedures where a bag of blood will be released.
b. Pediatric patients (under the age of 18)
1) All red blood cells are supplied as leukocyte-reduced by default.
2) All platelets are supplied as an aliquot of leukocyte-reduced, single donor
(apheresis) units.
3) Cellular transfusion products (red blood cells and platelets) are selectively
gamma-irradiated. Pediatric patients that should receive gamma-irradiated
products include:
a) Patients with a history of cancer or chemotherapy.
b) Patients with a history of organ/bone marrow/stem-cell transplant.
c) Patients on immunosuppressive medication.
d) Patients with congenital immune deficiencies.
e) Patients with undiagnosed failure to thrive or undiagnosed chronic diarrhea,
prior to exclusion of an underlying immune deficiency.
c. Adult patients
1. All platelets are supplied as leukocyte-reduced, single-donor (apheresis) units
2. Patients undergoing coronary bypass surgery will receive leukocyte-reduced red
blood cells by default.
3. In non-coronary bypass patients, cellular transfusion products (red blood cells
and platelets) are selectively leukocyte-reduced and gamma-irradiated.
Policy No:
Previous Policy No.:
Policy Creation Date:
Most Recent
Review/Revised Date(s):
Approved by:
CLIN_092
CLN-B003, CLN-B004, CLN-B005, CLN-B006, ADM 100.076.
05/09/1997
01/18/2017
Policy Committee: 05/09/1997; 02/23/2000; 08/22/2001;
08/28/2003; 7/8/2004; 8/12/2004; 11/10/2005; 09/22/2006;
05/10/2007, 08/14/2008, 09/09/2010; 02/10/2011; 02/09/2012;
03/08/2012, 04/11/2013; 05/08/2014; 07/10/2014; 08/13/2015;
01/18/2017
EXHIBIT A
EDWARD HOSPITAL
INFORMED CONSENT TO TRANSFUSION FOR BLOOD OR BLOOD COMPONENTS
In the course of your treatment, it may become necessary to administer a transfusion of blood or
blood components. This form provides basic information concerning this procedure and, if
signed by you, authorizes its performance by qualified medical personnel.
DESCRIPTION OF PROCEDURE:
Blood is introduced into one of your veins, commonly in the arm, using a sterilized disposable
needle. The amount of blood transfused, and whether the transfusion will be of blood or blood
components is a judgment the physician will make based on your particular needs.
RISKS:
The transfusion is a common procedure of low risk.
MINOR AND TEMPORARY REACTIONS ARE NOT UNCOMMON, including a slight
bruise, swelling or local reaction in the area where the needle pierces your skin, or a nonserious reaction to the transfused material itself, including headache, fever or a mild skin
reaction, such as rash.
Serious reactions are possible, though very unlikely and include severe allergic reaction
(shock) and destruction (hemolysis) of transfused blood cells.
Infectious diseases which are known to be transmitted by blood transfusion include
CERTAIN TYPES OF VIRAL HEPATITIS, a viral infection of the liver, HUMAN
IMMUNODEFICIENCY VIRUS (HIV-1,2) infection, a viral infection known to cause
ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) AS WELL AS CERTAIN
OTHER BACTERIAL, VIRAL AND PARASITIC DISEASES. While a minimal risk of
acquiring an infectious disease from transfused blood exists, in accordance with Federal
and State law all due care has been taken in donor selection and testing to avoid
transmission of disease.
ALTERNATIVES:
If loss of blood poses serious threats in the course of your treatment, THERE IS NO
EFFECTIVE ALTERNATIVE TO BLOOD TRANSFUSION. However, if you have any further
questions on this matter, your physician will fully explain the alternatives to you if it has not
already been done.
I, _____________________________, have read/had read to me the above. I understand the
matters bearing on the decision whether or not to authorize a transfusion of blood or blood
components. I have no questions which have not been answered to my full satisfaction. I
hereby consent to such transfusion as my physician may deem necessary or advisable in the
course of my treatment.
_______________
Date
__________________________________________________
Signature of Patient, Parent or Legal Guardian
(Circle One)
__________________________________________
Witness to Signature (title or relationship to patient)
EXHIBIT B
PREFERRED ADULT IV ACCESS
Blood Product and Category
Rapid transfusions in adults
Red Blood Cells
Routine transfusions in
adults
Red Blood Cells
Other Blood Products and
Plasma Derivatives
IV Access
14-18G or Central Venous Access
Devices
18-22G or Central Venous
Access Devices
Any size adequate
EXHIBIT C
ADULT
Blood
Component
Packed red
blood cells
(RBCs)
Same RBC
mass as whole
blood but with
80% of the
plasma
removed
Platelets
Apheresis
platelets contain
the equivalent
of 6-10 units of
platelets
harvested from
a single donor.
Fresh frozen
plasma (FFP)
plasma which
has been
Indications
Symptomatic
anemia with Hgb
</= 7
Coronary
syndrome with
Hgb </= 8
Hgb<10 with
sepsis, severe
CAD or other
cause of low O2
Platelet count </=
20
Platelet count </=
50 with surgery or
bleeding
Platelet count
</=100,000 with
brain or eye
surgery
Platelet function
defect
Reversal of
coagulation defect
Thrombotic
Tubing/Infusion
Rate
Standard Y-type
blood
administration
set (contains an
integral filter)
Monitoring
Nurse remains
with the patient
during the first 15
minutes of the
transfusion.
Set Infusion
pump at 120ml
to deliver 30ml
for the first 15
minutes
Baseline vital
signs, 15 minutes
after initiation,
then hourly until
completed
Standard Y-type
blood
administration
set (contains an
integral filter)
Nurse remains
with the patient
during the first 15
minutes of the
transfusion
Complete
transfusion
within 20 – 30
minutes or at the
fastest rate the
patient can
tolerate.
Baseline vital
signs, 15 minutes
after initiation,
then hourly until
completed
Standard Y-type
blood
administration
set (contains an
Nurse remains
with the patient
during the first 15
minutes of the
Nursing
Considerations
Infuse within 4
hours.
Use only with
normal saline
solution.
Keep in mind
that largevolume
transfusions of
separated from
whole blood
(through
centrifugation
and removal of
supernatant
plasma) within 8
hours of
collection. The
quick removal of
plasma from the
red cell mass
and subsequent
freezing
preserves most
of the clotting
factors in the
product.
Albumin 5%
(buffered
saline);
albumin 25%
(salt-poor)
A small plasma
protein
prepared by
fractionating
pooled plasma
Thrombocytopenic
Purpura (TTP),
Hemolytic Uremic
Syndrome (HUS),
HELLP Syndrome
Cryoprecipitate
is prepared from
FFP units
thawed at 1-6
degrees. The
insoluble protein
at this
temperature is
harvested and
stored in a
frozen state.
The product
contains a
concentrate of
fibrinogen,
factor VIII:C,
von Willebrand
DIC
Active bleed
Disseminated
intravascular
coagulation (DIC),
factor deficiency
To replace volume
lost because of
shock from burns,
trauma, surgery,
or infections
To treat
hypoproteinemia
(with or without
edema)
Active bleed
Fibrinogen < 150
Congenital
coagulopathy
integral filter)
Complete
transfusion
within 20 - 30
minutes or at the
fastest rate the
patient can
tolerate.
Use
administration
set supplied by
manufacturer
and set rate
based on
patient's
condition and
response.
Standard Y-type
blood
administration
set (contains an
integral filter)
transfusion
FFP may require
correction for
Baseline vital
hypocalcemia
signs, 15 minutes because citric
after initiation,
acid in FFP
then hourly until
binds calcium.
completed
Once FFP is
thawed, it can be
stored at
refrigerated
temperatures for
up to 24 hours.
Keep in mind
that albumin is
contraindicated
in severe
anemia.
Administer
cautiously in
cardiac and
pulmonary
disease because
heart failure may
result from
circulatory
overload.
Keep in mind
that
cryoprecipitate
must be
administered
within 4 hours of
thawing.
Once the
product is
thawed and
pooled, it must
remain a room
temperature to
prevent reprecipitation of
the insoluble
protein.
factor and factor
XIII.
EXHIBIT D
CHILDREN
Blood Product
Packed Red
Blood Cells
(PRBC’S)
Indications
Hgb </= 8 with
chronic anemia
not responsive to
medical therapy
Hgb </= 10 and
receiving
chemotherapy or
irradiation
Infusion Rate
2.5ml/kg/hr for
the first 15
minutes, if
tolerated then
5ml/kg/hr, not
to exceed
250ml/hr
Monitoring
Baseline vital
signs, at 15
minutes prior
to increase,
then hourly
Tubing
Y-set
Blood
tubing
FYI
Hang within 30
minutes and
completed
within 4 hours
of unit arrival
Within one
hour, no
greater than
30ml/kg/hr
Baseline vital
signs, after
infusion and
30 minutes
post infusion
Y-set
Blood
tubing
Do not
refrigerate
No greater
than
0.5ml/kg/min
Baseline vital
signs, every
30min for one
hour, then
every hour
until complete
Y-set
Blood
tubing
Once spiked
must be
finished within
4 hours,
preferably
within 1 hour
See formulary
or physician
order for rate
Baseline vital
signs and
infusion
Non
filtered,
vented IV
Must be
discarded 6
hours after
Hgb </= 13 with
severe
cardiopulmonary
disease
Active bleeding or
active surgical
blood loss
Platelets
Fresh Frozen
Plasma (FFP)
Albumin
Complications of
sickle cell or
chronic
transfusion
regimen for
hemoglobinopathy
Stop and/or
prevent bleeding
in patients with
decreased or
dysfunctional
platelets
Bleeding
prevention,
Coumadin
reversal,
hemorrhagic
clotting factor
deficiencies
Plasma volume
expansion,
replacement of
albumin
Cryoprecipitate
Fibrinogen
deficiencies
5-15 minutes,
slowly
completion
vital signs
Baseline vital
signs and
infusion
completion
vital signs
tubing
spiking bottle
Y-set
Blood
tubing,
replace
after 4
hours
Keep room
temperature
and infuse
within 4 hours
Exhibit E
Blood/Blood Component
ABO / Rh Compatibility
RED CELL (PACKED CELL) TRANSFUSION
+ = Compatible
DONOR
O+
A+
B+
O+
+
+
A+
NC
+
+
NC
B+
NC
NC
+
AB+
NC
NC
NC
O-
+
+
A-
NC
+
+
NC
B-
NC
NC
+
AB-
NC
NC
NC
NC = Not Compatible
PATIENT
AB+
O-
+
+
+
+
+
+
+
+
A-
B-
AB-
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
+
+
NC
+
+
NC
NC
NC
+
NC
NC
NC
+
+
+
+
FFP TRANSFUSION (ADULT/PEDIATRIC)
+ = Compatible
DONOR
O+
A+
B+
AB+
O+
+
+
+
+
NC = Not Compatible
A+
NC
B+
NC
PATIENT
AB+
ONC
+
+
NC
NC
NC
+
+
NC
+
+
+
+
+
ANC
BNC
ABNC
+
NC
NC
NC
+
+
NC
+
+
OABAB-
+
+
+
+
NC
NC
NC
+
NC
NC
NC
+
+
NC
+
+
+
+
+
+
NC
NC
NC
+
NC
NC
NC
+
+
NC
+
+
PLATELET TRANSFUSION SELECTION FOR ADULTS/PEDIATRICS
 For non-bleeding patients, ABO matched is given if possible. If the patient is actively
bleeding, it is acceptable to give platelets of any ABO type. After three ABO “off type”
platelets are given, the blood bank medical director must decide if additional off type
platelets will be transfused.
 Avoid giving platelets from an Rh positive donor to an Rh negative recipient with
childbearing potential. (Platelets are devoid of Rh (D) antigen but contaminating red
cells in the product may cause sensitization).
CRYOPRECIPITATE FOR ADULTS/PEDIATRICS
 All ABO groups and Rh types are acceptable. After several ABO “off type” pooled
cryoprecipitate is administered, the blood bank medical director must decide if
additional off type product will be transfused.
INFANT TRANSFUSION BLOOD AND BLOOD PRODUCT SELECTION
 Most neonatal patients are transfused with O negative packed cell products which
have been leukoreduced, irradiated, etc. If non – O blood is transfused, refer to the
adult guide for information regarding compatible blood types. Stricter matching
applies to transfusions of non-red cell products. For neonates, it is important to
transfuse Group AB or group identical products.