PRINCIPLES OF GOOD CLINICAL PRACTICE IN TRANFUSION MEDICINE

  • Blood is a scarce and expensive resource, and carries risks of adverse reactions and transfusion-transmitted illnesses
  • Use blood appropriately, that is, to treat conditions that can lead to significant morbidity or mortality, which cannot be prevented or effectively managed by other means
  • Minimise transfusional needs by:
    • Early diagnosis and treatment of anaemia
    • Good anaesthetic and surgical management
    • Use of simple alternatives to transfusion when appropriate, e.g., IV fluids as first line treatment of
      hypovolemic shock
    • Prescribe transfusion according to individual needs, using clinical signs and symptoms, and expected outcome, but NOT according to Hb level only
  • Blood should not be transfused unless it has been:
    • Obtained from appropriately selected donors (voluntary non-remunerated donors)
    • Screened for transfusion-transmissible infections, e.g., malaria, HIV, hepatitis B and C, and syphilis
    • Tested for compatibility between the donor’s red cells and the antibodies in the patient’s plasma in accordance with national guidelines
  • Guidelines and procedures for requesting, administering, and recording blood transfusion should be clearly spelled out, and strictly followed to avoid catastrophic mistakes
  • Ensure the transfused patient is closely monitored and that there is immediate response if any adverse reactions occur

Do not use blood tranfusion to:

  • Expand blood volume unless there has been blood loss of >30% of total volume
  • Enhance wound healing
  • “Top up” Hb for surgery
  • Improve general well-being of the patient in patients with on-going fluid losses, e.g. surgical blood loss