Further Information Is Available By Contacting The Medical Director of the Transfusion Medicine Service: Zbigniew.M.Szczepiorkowski, M.D. or the Blood Bank Medical Director, Nancy Dunbar M.D.
Refer to the Transfusion Committee Policy, Blood Transfusion and Blood Component Administration, for complete procedural information.
Following are policies relating to the transfusion of blood at Dartmouth Hitchcock Medical Center.
Use eD-H to request transportation for blood component pick up or call transportation services at 5-5580 during downtimes or use a unit based runner to pick up the blood component. The individual picking up the component(s) from the Blood Bank must present with their employee identification badge and will provide the following information on a slip of paper ("pink" pick-up slips are available on patient care units or from stores) to ensure the correct component(s) for the correct patient is taken to the transfusing site:
No blood is to be put into unit/ward refrigerators. If blood cannot be transfused promptly after it has come to the floor it must be returned to the Blood Bank.
Blood for only one patient can be picked up at one time to reduce the potential of a patient receiving the wrong unit of blood/blood component.
No more than one unit of blood for any patient will be released from the lab at a time unless the patient is actively bleeding. During bleeding emergencies, the Transfusion Medicine Service will be notified by the Blood Bank to provide assistance, if necessary.
A temperature indicator device will be attached to emergency release units and to each unit going to the OR to ensure that the unit temperature does not exceed 6°C. If the indicator dot has turned red, the unit has exceeded 6°C and may not be returned to the Blood Bank inventory. The unit may still be transfused to the patient as long as the transfusion is completed within four hours from the time of dispense. All non-transfused units should be promptly returned to the Blood Bank.
Do not request blood components until you are ready to transfuse. Products that are returned without temperature monitoring devices must be discarded.
Blood transfusion may be started by licensed physicians, transfusionist certified RNs, Certified Perfusionists or EMT/paramedics following standard hospital procedures.
If the blood lock device does not open by using the code on the patient's wristband, the product must be immediately returned to the Blood Bank and the Blood Bank should be notified by phone at 5-7207. A new sample may be required before transfusion can be given.
PRIOR TO INITIATING TRANSFUSION, THE TRANSFUSIONIST MUST INSURE POSITIVE IDENTIFICATION BETWEEN PATIENT, BLOOD COMPONENT AND RECORD OF TRANSFUSION FORM.
If any error is detected in the verification and/or identification process, immediately contact the Blood Bank at 5-7207. Do not initiate transfusion until all discrepancies have been satisfactorily resolved.
In appropriate spaces of the component administration record label in certain areas, during downtime procedures or in the electronic medical record (EMR) indicate:
Blood may be run through a primary set, secondary set, or Y-type administration set with normal saline. An appropriate filter is required. Blood may not be run through any solution other than normal saline because of the danger of causing clotting or damage to cellular elements. No medication may be added to the blood or blood component.
Inpatients with normal cardiovascular status should be infused blood at a rate specified by the ordering provider. In most instances, this will require two to four hours for red cells. Should very slow infusion be necessary the Blood Bank should be asked to divide the unit into aliquots which can be stored at controlled temperatures until required. Careful monitoring of the patient is essential.