TRANSFUSION CHECKLIST

For references, refer to Bloody Easy Blood Administration Version 3, Summary: Transfusionist’s Accountability: Transfusion Checklist (page 80-89).
Unequivocal (unmistakeable) identification of the patient is mandatory.
Patient must be wearing a patient identification armband. Patient identification information must remain attached to the blood for the duration of the transfusion.

PRE-TRANSFUSION TRANSFUSION POST-TRANSFUSION

✓ Informed Consent ✓ Checking Blood Components/Blood Products ✓ Completing the Transfusion
• Per policy/procedure, questions addressed • Blood received matches transfusion order • Comply with expiry time specific for blood
• Exception: emergent, life-threatening bleed • At bedside, in physical presence of patient component/blood product
✓ Transfusion Order • 1. Patient Identification: surname, first name, Outside the expiry time, discard remainder
• Indication supported: labs, signs, symptoms unique identification number identical on • Component tubing: flush with 0.9 % NaCl
• Complete, required information included armband, order, transfusion & chart label/tag • Products given IV: flush (tubing/IV site) with
✓ Group & Screen Testing • 2. ABO, Rh(D) Blood Groups (only for compatible IV fluid
• Required for compatible blood components Components): identical/compatible on Group • Some hospitals require returning the empty
& screen test, CBS (Canadian Blood Services)
• ABO, Rh(D) blood groups, antibody screen blood bag to TML
label, transfusion & chart label/tag
(clinically significant antibodies) Otherwise dispose of blood tubing/bags in
• 3. Unit (Components) / Lot (Products)
• Label tube of blood at patient’s bedside biohazardous waste
Number: identical on CBS label (Components)
✓ Prepare the Patient • Re-assess patient and re-check vital signs:
/ manufacturer label (Products), transfusion &
• Educate: symptoms indicative of reaction - at end of transfusion
chart label/tag
• Assess for transfusion history and TACO risk - periodically post-transfusion (reactions
• 4. Visual Inspection & Expiry
factors; follow up if indicated Components: no clots, usual colour, ports
may occur 4 hours post-transfusion; for
✓ Prepare the Equipment intact, expires 4 hours after issue from TML dyspnea reactions up to 24 hours post
• Dedicated, patent IV (peripheral or central) Products: packaging/seal intact, colour as per transfusion)
• Compatible IV fluid (only 0.9 % NaCl manufacturer, vials/glass bottles – once
[sodium chloride] for blood components) entered/spiked, expires after 4 hours ✓ Documentation
• Blood components – tubing/filter (170-260 ✓ Patient Assessment and Vital Signs (for each unit) • File completed chart label/tag for each
microns); change after 4 units or 4 hours • Close monitoring/observation required component or product transfused on
• Platelets – always NEW/FRESH tubing/filter • Minimum: within 30 minutes of starting, patient’s health record (include start and
15 minutes after starting, upon completion stop times)
• Prime tubing/filter: blood or compatible IV
fluid • Temp, BP, pulse, respiratory rate, oxygen • Some hospitals require a completed
saturation; if TACO risk - chest auscultation “transfusion record” form returned to TML
• IV setup to stop abruptly & maintain TKVO:
✓ Infusion Rate (for each unit) • Record volume transfused, vital signs and
0.9% NaCl flush syringes + any fluid IV line
• 50 mL/hour for first 15 minutes; can be deferred patient assessments
or 0.9% NaCl IV line
if acute bleeding • If a transfusion reaction is suspected:
• Infusion Devices: if Health Canada
• Re-check after 15 minutes, if no indication of report to TML, document signs and
approved reaction then increase to rate as ordered
✓ Pick Up Blood from TML (Transfusion Medicine Lab)
symptoms, patient care
✓ Possible Transfusion Reaction
• Patient identification (surname, first name, • If any adverse/unexpected/serious symptoms,
unique identification number) and order STOP transfusion; refer to TTISS Reaction Chart

June 2021, version 1.0 Ontario Regional Blood Coordinating Network