Technical Aspects of the Administration of Blood Components

Recommended Procedure

• Components should be mixed thoroughly by inversion before use and then transfused through an intravenous line approved for blood administration and incorporating a standard (170-200 µm) filter to remove clots and aggregates. It is recommended to change giving sets according to the manufacturers after 3-4 units or every 8 hours.
• Normal Saline is recommended to prime a new IV administration set because;- air bubbles in the IV tubing can be seen more easily. There is less risk of wasting a precious blood product in the priming process and a reduced occupational health and safety risk of blood product spills at the end of the IV line. If the jelco tissues once the IV line is attached, Normal saline will have been instilled into the tissues rater than blood product.
• If the jelco tissues once the IV line is attached Normal saline will have been instilled into the tissues rather than a blood product.
• In neonatal and paediatric patients the priming with a blood product may be necessary to avoid infusion of excessive fluid amounts. Care should be taken to ensure the line is primed safely.
• The component must only be spiked/pierced immediately prior to use by one of the people who checked the patient’s identity and blood product.
• Vital signs (temperature, pulse, respirations and blood pressure) should be measured and recorded before the start of each unit/pack and the patient should be closely monitored for the first 15 minutes of each blood pack. Observations during the transfusion need to consider individual patient‘s clinical condition. Vital signs should also be taken at the completion of each blood pack.
• Patients should be transfused in an environment where they can be easily monitored and supported should an adverse event occur.
• No medication or solutions should be added to or infused through the same tubing with blood or components except 0.9% Sodium Chloride, Injection (BP). ABO-compatible plasma or 4% Albumin, or other suitable plasma expanders may be used with approval of the patient’s physician. Crystalloid and colloid solutions containing calcium (such as Haemaccel, Hartmann’s or Gelofusine) must never be added to or administered through the same intravenous line as red cells or component collected in an anticoagulant containing citrate as they reverse the anticoagulant effect, resulting in clotting.
• Plasma thawing devices, intravenous fluid pumps, blood warmers and bedside leucodepletion filters should all be used according to the manufacturer’s instructions. Their appropriateness and satisfactory validation for use for blood components should be established prior to use. Equipment should be monitored and undergo regular maintenance. Written procedures for the use of the equipment must be available for staff.
• If warming is required, an appropriate approved and monitored system must be used. Blood and blood components must not be warmed above 41ºC13.
• Thaw frozen blood components using an approved method such as a controlled waterbath at temperatures between 30 and 37 ºC or in an approved microwave device. Care must be taken to prevent contamination of entry ports. The use of watertight protective plastic overwraps is recommended. Do not thaw components in a domestic microwave oven or under hot water directly from the tap.
• Blood components have been prepared by techniques that aid in preserving sterility up to the time of expiration. If the container is opened in a fashion that violates the integrity of the system for any reason, the component expires four hours after opening. Transfusion of each individual unit should be completed prior to component expiry or within four hours, whichever is sooner.