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.
