Pre-hospital Blood Transfusion SOP Flashcards
Outline the contents of the blood transfusion SOP
- Applies to all clinical staff
- NICE Guidelines for volume resus
- Definitions and responsibilities
- Training requirements
- Considerations for use
- Indications
- On scene process
- PRF and transfusion record
- Management of suspected transfusion reaction
- Supply and restocking
- Incident reporting
- IPC
- Audit
Outline the NICE Guidelines suggested approach to volume resuscitation
- Restrictive until definitive control of bleeding
- Titrate to central pulse
- If TBI dominant condition be less restrictive
- Use crystalloids if blood unavailable
Outline the training section of the blood transfusion SOP
- Mandatory training every 2 years
- Practical training from LNAA
- Training records at LNAA
- Blood given by trained practitioner
- Blood to remain on base if no one trained
What are the main considerations for blood transfusion use?
- Precious commodity
- Haemorrhage control should precede administration
- TXA prior to blood
- Rule out none haemorrhagic causes
- Not the treatment for none compressible haemorrhage so should support speedy transfer
What is the indication for blood transfusion?
Traumatically injured with life-threatening hypovolaemic shock
- Sweating/pallor
- Collapsed veins
- Low/falling ETCO2
- Hypotension
- Air hunger
- Abnormal HR
- Altered mentation
Consider in TCA with compressible haemorrhage
Consider in MH with none traumatic cause
Describe the process for blood transfusion
- Consent
- Open the Credo
- Check the TinyTag - if green good to go, still ok if red and opened in the last hour
- Remove the product
- Check for clots, discolouration, haemolysis and expiry
- Administer warmed via filter line
- Continuous obs
- 1:1 ratio, consider calcium
- Dispose in orange clinical waste
- MHP pre-alert
Outline the standards for documentation for blood transfusions
- Type and unit number on HEMSbase, handover summary and photos onto EMAS electronic record
- I deceased needs to be on EPR
Outline the actions required if a transfusion reaction is suspected
Stop transfusion
Blood products returned to lab for assessment
Ensure details passed to receiving hospital
Datix
See appendix 2 of SOP
How is blood supplied to the airbase?
- LEBBS from LCH each day
- Stay with LNAA for 48hrs then returned
- Left in drop box if no one is in, put returning boxes into locker in afternoon
- Sign proof of delivery form
- Consider mid-shift resupply if required
Take to LCH if missed pick-up
What are the key performance indicators for blood transfusion audit?
100% get TXA
100% having 2 units get calcium
100% via warmer
