Forms and Labeling
  Ordering Transfusions
  Transfusion Procedure
  Audit Procedure
  Adult Transfusions
  Pediatric Transfusions
Informed Consent
  OR Schedule
  Massive Transfusion
  Trauma Activated Transfusion Algorithm (TATA)
  Bloodloc System
  Block Release Protocol
  Available Components
Transfusion Medicine Service Informed Consent

Further Information Is Available By Contacting the Medical Director of Transfusion Medicine Service: Zbigniew.M.Szczepiorkowski, MD or the Blood Bank Medical Director, Nancy Dunbar M.D.
  1. Written documentation of informed consent will be obtained before all elective transfusions.

    Transfusions occurring in emergency situations will not require prior written informed consent. Documentation of need of emergent transfusion without consent shall be present in the chart.

    All elective surgeries requiring a "Type and Screen" or crossmatching preoperatively according to the Surgical Blood Order Schedule, or any procedure in which the physician has ordered blood to be crossmatched, will have a written informed consent for transfusion completed prior to surgery.

  2. Responsibility for explaining risk, benefits and alternatives to the patient and obtaining the consent will be the responsibility of the attending physician performing the procedure. This responsibility may be delegated to another provider caring for the patient.

  3. A consent for transfusion will be valid for:
    Non-surgical patients: A period of one year, unless revoked.

    Surgical patients: The perioperative period and any subsequent treatment durint the admission related to the surgical treatment or the condition that required it.

  4. Verification of completion of the informed consent process will be the responsibility of the transfusionist and, in surgical cases, the nurse verifying the completion of the surgical consent form.

  5. A written, standard informed consent document will be used.


As of January, 2012, the best estimates of transfusion risks with allogeneic transfusion were:

Viral Transmission
HIV 1/1,500,000 units
HBV 1/500,000
HCV 1/1,100,000
Bacterial Contamination
Red cell units 1/500,000
Platelets < 1/75,000
Immunologic Complications
Acute hemolytic transfusion reaction 1/76,000
Transfusion-related acute lung injury (TRALI) 1/1,200 to 1/190,000
Febrile reaction 1/100 to 1/1,000
Urticarial reaction 1/3 - 1/100

Note that platelet transfusions using platelet concentrate units and cryoprecipitate transfusion involve pooling of multiple units, and thus risks of infectious disease exposure increase with the size of the pool.


Preoperative autologous donation is available. If the patient wishes to donate at DHMC, complete the order form (found in all surgical clinics) and refer the patient to the Donor/Apheresis Room (ext. 3-3775). The patient may also donate through the American Red Cross or any hospital that is appropriately accredited or licensed.

Intraoperative and/or post-operative red cell recovery may also be feasible.

Additional Information

If you need additional information or assistance in dealing with patient questions, please contact the Blood Bank (ext. 5-7207) and ask to speak to the Transfusion Medicine Physician.

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