- The Difference between a Type and Screen and a Crossmatch.
- Go and sign the consent form with the patient. Here is a sample consent form, the hospital has specific forms to order.
- Don’t give two units when one unit will do.
- Each unit of packed red blood cells (PRBCs) is expected to raise circulating hemoglobin (HGB) by approximately 1 g/dL or increase the hematocrit by 3 %.
- Order the transfusion products in the EHR and also order for the H/H should be rechecked a few hours after the transfusion.
- Understand transfusion reactions and treatment.
Threshold for Transfusion & Indications for Transfusion.
PRBCs
- 7 is the threshold for RBC patients who are ill but don’t have cardiac disease.
- 7 is also the threshold for transfusion of PRBCs in an otherwise healthy stable patient with upper an upper GI bleed.
- >7 is the threshold for hypotensive patients with severe bleeding. Transfuse before hemoglobin reaches 7.0 g/dL to prevent the significant decrease below this level that would occur with just fluid resuscitation.
- 8 is the threshold of transfusion for a hemodynamically stable patient with known CVD and significant upper GI bleeding.
- Transfusion of PRBCs is indicated in patients with an acute hemorrhage that results in the loss of >1500 mL of blood or >30% of total blood volume.
- A sickle cell crisis is also an indication for transfusion.
- Transfusion is also indicated for patients with acute symptoms related to their anemia (e.g., shortness of breath, weakness, altered cognition, angina, and severe heart failure) when they are unable to function as a result of their symptoms.
Platelets
The threshold for prophylactic platelet transfusion in most patients is 10,000 / microliter. Platelet transfusion decreases the risk of spontaneous bleeding. A count of 50,000 / microliter is an indication for transfusion in a patient undergoing an invasive procedure.