• RED BLOOD CELLS (Erythrocytes) – The most abundant
cells in our blood; they are produced in the bone marrow and
contain a protein called hemoglobin that carries oxygen to our
• WHITE BLOOD CELLS (Leukocytes) – They are part of
the immune system and destroy infectious agents called
PLASMA – This is the yellowish liquid
portion of blood that contains electrolytes,
nutrients and vitamins, hormones, clotting
factors, and proteins such as antibodies to
PLATELETS (Thrombocytes) are carried in
the plasma; they clot together in a process
called coagulation to seal a wound and
prevent a loss of blood.
The average adult has about FIVE liters of blood
which makes up 7-8% of their body weight.
Blood is living tissue that carries oxygen and nutrients
to all organs and carries carbon dioxide and other
waste products back to the lungs, kidneys and liver for
It also fights against infection.
Genetics of Blood Types
blood type is established by specific GENES inherited
one gene from MOTHER and one from FATHER.
•These genes determine your blood type by causing
proteins called AGGLUTINOGENS to exist on the
surface of all of your red blood cells.
There are 3 alleles or genes for blood
type: A, B, & O. Since we have 2
AA or AO = Type A
BB or BO = Type B
OO = Type O
AB = Type AB
•How common is your blood type?
The presence of the protein, or
lack of it, is referred to as the Rh
(for Rhesus) factor.
Rh positive (Rh+). If your blood
Rh negative (Rh-).
A+ AB+ BAB+
•Who can give you blood?
•People with TYPE O blood are called
Universal Donors, because they can give
blood to any blood type.
•People with TYPE AB blood are called
Universal Recipients, because they can
receive any blood type.
•Rh + Can receive + or •Rh - Can only receive -
• Blood samples – Can be analyzed to determine blood type
and DNA, which can be matched to possible suspects.
For a blood transfusion to work, the donated
blood must match that of the recipient’s.
If the blood is not matched properly, then the
immune system of the recipient will attack the
• Immune System Response
After birth the immune system makes antibodies
that act against the antigens not found on the
Antibodies are present on the white blood cells
Patient Details required on form
Blood Group (if known)
Previous transfusion and obstetric history
Reason for request; Present Hb (if known)
Location, Date and Time of expected transfusion
Date of request
Type of blood (Packed cells, whole blood, G&S only); Number of
Name, Bleep number and Signature of person requesting the
LABELS ARE NEVER
ALLOWED ON THE
FORMS OR THE
• Check patient details on wrist band vs form.
• Use Pink cross match bottle (In use nationally)
• Details required on Blood Sample tube
- Full names of patient
- DOB; Gender; Hospital number
- Signature of person taking blood
- Date and Location
• Take blood tube down to the blood bank if required
urgently – you will also meet the cross match team.
PATIENT LABELS WILL NOT BE ACCEPTED!
Setting up the Transfusion
• Units of blood are stored in the
‘blood bank’ fridge or theatre
• You will need all the patient’s
details prior to going to collect
any blood products
• Check details of blood report
form against unit of blood.
• You will need to sign for the unit in blood bank
• Start transfusion within 30
minutes of blood being removed
from the fridge.
•The Wright, Wright
•The Right Blood,
•The Right Patient,
•The Right Time!
labs can cross
match blood in 20
TWO to check details of blood
Check details on the unit of blood
against those written on the form
against patient’s wrist band.
ALL MUST BE CORRECT.
Prescribe Transfusion on IV chart
Rate of each unit (slowest approx 4 hours)
Saline (100ml+) Before – After
(40mg) is often given with each or every
other unit (IV or PO) to stop potential fluid
overload. Not required when patient is
Allergic reactions to an unknown component
in donor blood are common, usually due to
allergens in donor plasma or, less often, to
antibodies from an allergic donor. These
reactions are usually
Simultaneous fever is common
During or immediately
after the transfusion.
Febrile Nonhemolytic Reaction
Febrile reaction without hemolysis.
Antibodies directed against WBC from otherwise
compatible donor blood are one possible cause. This cause
is most common in multitransfused or
•Blood Transfusion complication
The most common Complications
of transfusion are
Febrile Nonhemolytic & ChillRigor Reactions.
Clinically, febrile reactions consist of a
increase of T ≥ 1° C, chills, and
sometimes headache and back pain.
Simultaneous symptoms of allergic
reaction are common. Because fever and
chills also herald a severe hemolytic
All febrile reactions must be
investigated as above, as with
any transfusion reaction.
Febrile Nonhemolytic Reaction
Occurs towards the end of Paracetamol and
or up to hours after
Blood Transfusion complication
The Most serious complications
Aacute Hemolytic Reaction
due to ABO incompatible
transfusion and transfusion-related
acute lung injury, which have very
high mortality rates
most common cause is
transfused of non-matched
blood mostly to clerical error
• The most common symptoms are
chills, rigors, fever, dyspnea, lightheadedness, urticaria, itching, and flank
• If any of these symptoms (other than
localized urticaria and itching) occur,
the transfusion should be stopped
immediately and the IV line kept open
with normal saline. The remainder of the
blood product and clotted and
anticoagulated samples of the patient's
blood should be sent to the blood bank
Occurs within a few
mls of starting
STOP THE BLOOD!
Treat complications –
ARF and DIC
What is the action ?
Early Recognition of symptoms suggestive of a
Prompt Reporting to the blood bank are
The remainder of the blood
product and clotted and
anticoagulated samples of the
patient's blood should be sent
to the blood bank for
• Malaria is transmitted easily through infected RBCs.
Many donors are unaware that they have malaria, which
may be latent and transmissible for 10 to 15 yr. Storage
does not render blood safe. Prospective donors must be
asked about malaria or whether they have been in a
region where it is prevalent. Donors who have had a
diagnosis of malaria or who are immigrants, refugees, or
citizens from countries in which malaria is considered
endemic are deferred for 3 yr; travelers to endemic
countries are deferred for 1 yr. Babesiosis has rarely
been transmitted by transfusion.