Blood Components Independent Double Checks Chris Downey RN CPN(C) MSc RNFA
Dec 30, 2015
Blood ComponentsIndependent Double Checks
Chris Downey RN CPN(C) MSc RNFA
Blood Components Independent Double Checks
What are classed as blood components?Autologous whole blood (lifespan of 35
days)Red blood cells (RBCs or packed cells)Frozen plasma (FFPs)Cryoprecipitate (Factor VIII)Platelets
Blood Components Independent Double Checks
Blood products are never stored in a regular fridge Brought into the room in a cooler with cool paks
Bacterial proliferation &/or loss of function in blood
components
2 blood fridges in the OR, one in Connell anesthesia room and one in Kidd coreWhere there is a definite need, Type and CrossWhere there is a potential need, Type and Hold
(KGH Blood Schedule)
Blood Components Independent Double Checks
Why Independent Double Checks? Literature on blood administration states:
Errors of commission 1 in 1000 Errors of ommission 1 in 100 Errors in high stress environments with rapidly occuring
events 1 in 4 Serious Hazards of Transfusion reports (SHOT) demonstrate
cases of incorrect transfusion often result from a sequence of errors involving failure to detect the incorrect identity of the patient &/or the blood component.
Blood Components Independent Double Checks
Policies controlling Blood Administration (Adult & Peds, not Neonates) Intranet > KGH Community > Admin
Policy Manual 06-040 Consent for Blood Administration 13-010 Patient Identification 20-020 Administration of Blood Products 20-025 Administration of Plasma Derivatives
Blood Components Independent Double Checks
According to Policy Prior to infusing RBC’s 2 practitioners (RN, RT, Docs,
Perfusionists) will perform independent double checks- Exception: In an emergency situation where the
practitioner is of the opinion that the time to do a double check would put the patient at risk of serious harm.
Blood Components Independent Double Checks
Documentation All blood products have a removable label that may
be attached to the “Blood Components/Products Transfusion Record” (pink sheet-SAP # 278 )
In the OR, when blood has been checked, Nurses will put initials on the removal label
Do not put initials on the bag or the CBS label (bag cannot be reused by blood services)
Blood Components Independent Double Checks
B79269
Blood Components Independent Double Checks
Blood band #Patient Name
Blood Unit # Compatibility
Blood Components Independent Double Checks
Blood band #Patient Name
B79269
Blood Components Independent Double Checks
B79269
B79269
Blood Unit #Blood band #
Compatibility
ABO Rh
Blood Components Independent Double Checks
If any part of the check is not correct:
DO NOT TRANSFUSE
Determine if the case should proceed if the appropriate amount of blood is not available;
Identify to team members that there is a discrepancy, repeat the check; and
If discrepancy still exists give unit(s) to the Perioperative RN and call Blood Bank (4188) stating the discrepancy.
(…You may want to ask Blood Bank if they require more serum or are they able to retype and cross with what they have)