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Single Unit Blood Transfusion Guideline Single Unit Blood Transfusion Guideline

Single Unit Blood Transfusion Guideline - PowerPoint Presentation

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Single Unit Blood Transfusion Guideline - PPT Presentation

for Laboratory Staff Based on the Patient Blood Management Guidelines Be SINGLE m inded Single Unit Transfusion Guideline Applies to The stable normovolaemic inpatient who is ID: 503917

blood unit single patient unit blood patient single transfusion staff guideline bleeding risk guidelines patients minded actively symptoms evidence reduced medical compliance

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Slide1

Single Unit Blood Transfusion Guideline for Laboratory Staff

Based on the

Patient

Blood Management Guidelines

Be

SINGLE

m

indedSlide2

Single Unit Transfusion Guideline

Applies to:

The stable, normovolaemic

inpatient who is NOT actively bleeding is NOT in an operating theatreHaemoglobin as defined in the Patient Blood Management GuidelinesSlide3

The Guideline

Transfuse one unit,

then

reassess the patient for clinical symptoms before transfusing anotherIf the patient’s symptoms are relieved, don’t transfuse more unitsEvery unit is a new clinical decision Base decision on patient symptoms, not only on haemoglobinSlide4

Single Unit Transfusion Guideline

WHY

Current practice does not align with evidence-based recommendations

Prescribing a single unit of blood may reduce the risk of an adverse event:Harm from transfusion is dose dependentTransfusion is an independent risk factor for increased morbidity, mortality and length of stay.There is a lack of evidence for benefit of transfusion in a non-bleeding patient.Five Drivers Shifting the paradigm from Product-focused Transfusion Practice to Patient Blood Management” Axel Hofmann, Shannon Farmer,

Aryeh

Shander

.

The Oncologist

2011;16(

suppl

3):

3-11

Strategies to

preempt

and reduce the use of blood products: an Australian perspective. Hofmann, A et al.

Curr

Opin

Anesthesiol

2012, 25:66-73.Slide5

Be SINGLE m

inded

HOW

When blood is ordered for a patient…ASK:Is the patient actively bleeding?What is the current haemoglobin? *EXPLAIN:Only one unit will be issued, in compliance with the Patient Blood

M

anagement

G

uidelines

*If

Hb

<70 g/L a 2 unit request likely to be acceptable

Note:

Hb

<80g/L for patients with acute coronary syndrome

Hb

<100g/L for renal patients.Slide6

Indications for a Second unit

Active blood loss

Hb

< 70g/L for general patientsHb <80g/L for cardiac patients** See Patient Blood Management Guidelines for other patient groupsOn going chest painLess than 8g/L rise in haemoglobin following first unitSlide7

Single Unit Transfusion

Empowered Staff:

Laboratory staff can “gate-keep” compliance.

Guideline document is accessible in laboratory – prompt for questions about compliance.Inclusion criteria for a second unit is defined.Support from champions to resolve challenges to requests: (medical staff, haematologists) Slide8

Be SINGLE m

inded

Refer disputes to medical staff / champions:

Politely suggest that the request is outside the guidelinesRe-confirm that the inpatient is NOT actively bleeding or NOT in the operating theatreProvide blood if the patient is bleedingRemain calm, polite and professional, and refer the caller to appropriate medical support staff.Slide9

Be SINGLE mindedSlide10

Single Unit Transfusion Policy

Benefits:

Safer, evidence based transfusion

PLUS:Reduced risk for non-infectious adverse eventsReduced demand on limited blood supplyReduced risk from new infectious agentsBe SINGLE minded