BLOOD WASTAGE
MIRCA
HOSPITAL KEPALA BATAS
23.11.23
JAN – NOV 2023: 5 CASE
12.04.23 • 08.50 am - 09.25 am
• 08.10 pm - 09.50 pm
08.05.23
• Spelling error
• 10.45 am - 11.25am
11.10.23
• Incomplete name
• 09.00 am - 09.43 am
22.11.23
• Decided for alternative
• 09.46 am – 12.10
22.11.23
• IJC leak, unable to proceed with HD
BACK TO BASIC
The purpose of a transfusion
is to provide the blood / blood
component(s) that will improve the
physiological status of the patient.
The quality of blood & blood component
Blood Cold Chain
BLOOD COLD CHAIN
- Blood loses its
ability to transport O2
or CO2
- Risk of bacterial
contamination
BLOOD COLD CHAIN
- Blood loses its ability
to transport O2 or CO2
- Risk of bacterial
contamination
BLOOD COLD CHAIN
- Blood may be damaged,
and the transfusion of
such blood can be fatal.
PROPER HANDLING OF BLOOD & BLOOD COMPONENTS
WB/PC PLATELET CONC. CRYO/FFP
Storage +2 °C to +6°C Room Temperature +20°C -18°C to - 25°C (3mths)
SHOULD be to +24°C on AGITATOR <-25°C (36mths)
stored in SHOULD NOT be stored SHOULD NOT be stored or kept
BLOOD or kept in the wards in the wards
FRIDGE
Supply After Group specific Group Specific
crossmatch No crossmatching No crossmatching
required required
Should be thawed
Collection Blood box WITH Blood box WITHOUT ice Blood box WITH Ice
ice
Infusion - slow, - should be start as - within ½ hour after being
- completed soon as the pack is thawed.
within 4 hours. received from the BB - Not to be refrozen.
- Should not be
>30minutes
PROPER HANDLING OF BLOOD & BLOOD COMPONENTS
PROPER HANDLING OF BLOOD & BLOOD COMPONENTS
“30-MINUTES RULE”
Blood transfusion team can ensure the safety and
integrity of blood from time of collection to the
time of supply only.
Most transfusion services consider 30 minutes to
be maximum allowable time out of the
Temperature-monitored storage
AABB, Technical Manual, 16thEdition
PROPER HANDLING OF BLOOD & BLOOD COMPONENTS
The shorter the duration of
the blood outside the BB, the
better
• ✔ Blood must ONLY be collected
when its going to be transfused
PROPER HANDLING OF BLOOD & BLOOD COMPONENTS
WHEN TO Critical Q need to be asked
COLLECT THE before blood collection :
BLOOD FOR
TRANSFUSION
Right blood to collect?
Is time suitable?
Is patient prepared?
• Consent Up?
• IV line patent?
• Infusion set ready?
• Pt’s Temperature?
Is the team ready?
Is the blood ready?
ISSUE NEEDS ATTENTION
Thawing Plasma &
Cryoprecipitate
Plasma Thawer
• Not available in BB HKB
Waterbath
• Requires plastic overwrap
• Prevent contamination
Patient identification
Upon initial admission or seeing the patient, it is crucial to identify his or her identification correctly.
Steps identifying the patient include:
a) Ask the patient to tell you;
• Name (full name includes surname)
• Identification card number
• Date of birth
DO NOT state their name first and then ask to confirm or deny by a yes/ no response
Cont…
b) Ask their caregiver or relative if the patient is unable to tell you their name
(in unconscious patient, babies, children, mental disability and patient with dysphasia).
c) Do cross referencing with the patient’s identification card ( DO NOT refer to blood sample label
as only 26alphabets only to be printed in the label )
d) Use a translator if communication breakdown occur.
e) The inability to identify patient accurately by using methods given above, must be
documented properly in the patient’s health care record.
f) Once the patient is suspected to be admitted; a written (black)/ printed wristband
which consists of the name of the patient, IC or registration number must be placed
on the patient’s wrist.
Identity wristband
a) The information or identifiers to be recorded on it; (at least 2 identifiers) include:
• Full name of the patient
• Date of admission
• Date of birth and/or ID number (last four digit)
• Hospital registration number
• Name of the ward
b) The information on the wristband must only be in black and this may be written by
pen or printed directly on the wristband with certain printers.
Instances that require patient’s ID to be checked
1. upon admission or transfer/ transport to another hospital or other care setting
2. administration of all medicines
3. X- ray or imaging procedures
4. Surgical intervention or procedures
5. Blood transfusion/ blood products
6. Collecting of patient bodily fluid samples
7. Confirmation of death
How to ensure correct patient ID is checked and verified
Prior to any procedure, the clinician/ staff nurse must confirm the identification of
correct patient by asking (where possible) the patient to state :
• their name and hospital registration number/Identification number and
checking these details against the identity wristband and their medical record.
DO NOT state their name and ask them to deny or confirm by a yes or no reply.
• If the patient is unable to tell his or her name, refer to the identity wristband or
verify the details with a relative or caretaker.
• If the relative is not available, two (2) clinical staffs have to check and confirm
the patient identification and document it in the patient’s clinical record.
DO NOT proceed any procedure if the patient is not wearing his or her identity
wristband.
• If any clinician or staff nurse found a patient with a missing identity wristband,
he or she must immediately inform the in-charge staff nurse of the ward or
department.
• The identity wristband must remain on during the whole admission and to be
removed only on the day of discharge.
TAKE HOME MESSAGE
Maintain blood cold chain
Not to KEEP blood in ward and to
collect it ONLY when its going to be
transfused
If not used or to be used later, to
return immediately to blood bank
Blood Box is only for transportation,
not for storage
REFERENCES
Transfusion Practice Guidelines for Clinical and Laboratory
1 Personnel ( National Blood Centre, Ministry Of Health, 4th Edition,
2016)
Guidelines for the Rational Use of Blood and Blood Products (
2 National Blood Centre, Ministry Of Health, 2nd edition 2007)
3 AABB, Technical Manual, 16thEdition
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Thank You
