Consenting for Blood Transfusion

We frequently consent for Blood Transfusion, but what risks do we tell the patients about and how common are those risks?

Risk 1: Human error/Systems error

  • Blood components must be checked at the patient’s side.
  • Risk of patient misidentification at critical steps: Right Patient – Right Blood.

Mitigate 1:

  • Positive patient identification must be performed.
  • If possible, involve your patient in the checking process by asking them to tell you their full name and date of birth.
  • Blood samples must be labelled at the patient’s side.
  • Blood components must be checked at the patient’s side.

Risk 2: Transfusion-associated circulatory overload (TACO)

  • Higher risk in children, elderly, low body weight, hypertension and cardiac/respiratory/renal impairment.

Mitigate 2:

  • For patients at risk, transfuse slower and monitor observations closely including oxygen saturations.
  • Monitor fluid balance. Consider diuretics for those at risk.
  • In stable, non-bleeding adults, authorise one unit at a time according to body weight.
  • For patients at risk, transfuse slower and monitor observations closely including oxygen saturations.
  • Encourage your patient to report any breathlessness within 24 hours.

Risk 3: Adverse immune responses

Mitigate 3:

  • Enquire regarding previous transfusion history.
  • Patients are screened for antibodies to red cells (unless emergency).
  • Ensure observations are recorded and reviewed.
  • Encourage your patient to report any symptoms. For example: feeling hot or cold, shaking, pain, itching, rash and/or if something feels wrong.

Risk 4: Transfusion-transmitted infection

  • Blood donations are screened for HIV, hepatitis (B, C and E), HTLV and syphilis.
  • Risk of infection is very low; however, there will always be a small risk associated with having a blood transfusion.

Mitigate 4:

  • Strict adherence to cold chain compliance.
  • Prepare your patient for transfusion before collecting a blood component.
  • Strict adherence to Infection Control Policy, e.g. Intravenous access devices.

UK Blood Transfusion – HERE

Leave a Reply

Your email address will not be published. Required fields are marked *

9 + 14 =

This site uses Akismet to reduce spam. Learn how your comment data is processed.