Blood transfusion

During your admission at Western Health, we may need to give you a blood transfusion as part of your medical treatment. A blood transfusion is a procedure where you receive blood through an intravenous cannula (IV) inserted into a vein. The transfusion gives you certain components or parts of blood that your body needs to stay healthy.

The main components of blood that may be given by transfusion are:

Red blood cells

Their main job is to carry oxygen to the body's tissues and organs, which keep them healthy. If you have lost blood due to surgery, trauma, gastrointestinal (stomach) bleeding, or other conditions or you are anaemic (have a low red blood cell count) you may need a red cell transfusion.

Platelets

Platelets are small cells that prevent bleeding or stop bleeding from getting worse. You may need a platelet transfusion if you do not have enough platelets or they do not work properly.

Plasma

Plasma contains many substances, such as proteins. These substances help fight infections and help the blood to clot.

Albumin

Albumin is a protein that comes from plasma. It may be used to restore fluids your body has lost.

For adults

If you need a transfusion

You will need to have a blood test to establish your blood group and make sure your type is available. 

When you are having your blood test, you should help to check that all the details on the form and the tube are correct and exactly match. This includes your full name spelt correctly and your date of birth.

If you need to have more than one transfusion, or you need to have regular transfusions, you will need to have a blood test every time.

If you have not had a test and you need blood very quickly, you can be given a special blood type, until blood matched for you is available.

Identification details must always be checked with another person, such as a support person, family member or another member of staff.

Consent to having a transfusion

Treatment is your choice. Before you are given a transfusion you will be asked to give your permission, or what is called "informed consent".  Your doctor will explain the risks and benefits of having the transfusion and the risks if you do not have the transfusion. 

Use this quick checklist to help you make this choice:

• Do you know why a transfusion has been recommended?
• Have you asked about ways to avoid or reduce transfusion?
• Do you understand the risks?
• Have all your questions been answered?

If you have a cultural or religious belief and objection to blood transfusion, please discuss this with your doctor.

How you get a blood transfusion

A blood transfusion is given through an intravenous (IV) line inserted into one of your blood vessels. The procedure usually takes 1 to 4 hours, depending on how much blood you need. 

Prior to the transfusion commencing two nurses/midwives will check the product at your bedside, asking you to state your name and date of birth. Because there are many people with similar names and the same date of birth, all details must match exactly, or the blood product cannot be commenced. Even though you may be known to the staff, this check step is for your safety and must be done. The labels on the unit of blood product will also be checked carefully against details on your wristband and the paperwork. 

During the transfusion, you will be closely observed and have your temperature, heart rate and blood pressure taken many times by the nursing staff caring for you. Most people feel no different during a blood transfusion, but if you feel unwell in any way, tell staff immediately.

You may have a blood transfusion and be able to leave the hospital straight away. Before you leave, speak to staff about what to do if you feel unwell later.

Where the blood for transfusions comes from

All blood transfused in Australia comes from voluntary unpaid donors. The Australian Red Cross Blood Service is responsible for collecting and testing blood from donors. Before giving blood, a potential donor must undergo a confidential interview and complete a detailed questionnaire about their medical history and any factors that may affect the safety of donated blood. Those not suitable cannot donate.

Donated blood safety

The Australian Red Cross Blood Service has many safeguards to ensure the safety of blood for transfusion. After collection blood is extensively tested for infections including Hepatitis B and C, the T-cell lymphotrophic virus (HTLV), syphilis and the Human Immunodeficiency Virus (HIV which causes AIDS) and the blood group is also determined. Donor blood must pass all tests otherwise it is destroyed. 

Before you receive donated blood, a blood sample is taken from you to establish your blood group. The hospital transfusion laboratory checks both, your blood, and the blood you will receive to make sure they are compatible - this is called cross matching. In some cases, we may need to know if you have had a previous blood transfusion or have been pregnant in the last three months. When all tests are complete donated blood is released for transfusion.

Risks

Each blood product transfused carries a small risk of an adverse reaction however most blood transfusions go very smoothly. 

Most common risks of transfusion include:

• Minor reactions including a mild temperature, or skin rash
• Fluid overload, causing breathing difficulties, especially in older patients and those with heart disease

Other less common risks of transfusion include:

• Receiving blood that is not ‘matched’ to you. If incompatible donor blood is given to a patient in error, a haemolytic reaction can occur because of the patient's red blood cells being destroyed by the incompatible donor blood. This type of complication is rare since blood for transfusion is tested to make sure it is compatible and there are strict requirements for double checking before a transfusion commences to prevent such errors.
• Severe reactions, for example, allergy or acute lung injury
• Transmission of infection, for example, bacteria or viruses. Some infectious agents, such as HIV, can survive in blood and infect the person receiving the transfusion. We carefully test all donor blood for infectious diseases such as HIV and Hepatitis to prevent spread from person to person. The Australian Red Cross Blood Service estimate the risk of getting HIV from a transfusion is less than 1 in 1 million. 

Donating your blood in preparation for surgery

Preoperative autologous donation is the process of collecting and storing your blood before an elective procedure where you will require a blood transfusion. 

Autologous donation is not recommended except where you may have a rare blood group. This is for the following reasons:

• Your ability to tolerate several venesections (blood donations) taken over a short period of time, your age, adequate venous access (to enable blood to be taken) and reliable dates for elective surgery.
• Even though it is your blood, risks still exist with autologous blood.  Preoperative autologous donation can decrease your body's iron stores and iron is very important to ensure your blood can carry enough oxygen. These risks include bacterial contamination, clerical error and the increased chance of receiving a blood transfusion.
• The safety of autologous blood transfusion is not significantly different from donor blood transfusion in Australia. 

Reducing or avoiding the need for a transfusion

• Discuss with your health care team the best way to treat anaemia (low number or quality of red blood cells).
• If you are having surgery, discuss with your health care team the need to stop or withhold certain medications, so your risk of bleeding is reduced.
• Your health care team may suggest having your blood collected and returned to you, during some types of major surgery.
• If you do need a transfusion, you should receive only what is needed to relieve your symptoms. For example, once you have received one bag of red blood cells, you should then be reviewed to see if another bag is needed. One bag may be enough.

For parents

Babies receiving a blood transfusion

Children receiving a blood transfusion

For children

Billy Blood Drop

Place/Role: Clinic - Blood Transfusion - Community Based patients
Phone: 8395 9162

Fax: 8345 0753

Place/Role: Clinic - Blood Transfusion – Aged Care facility residents, Contact Immediate Response Service
Phone: 0419 392 030     

• GP referral for patients requiring blood transfusion
• Australian Red Cross Lifeblood: Patients:

This website is available for the public and is designed to provide you with information about receiving a transfusion, what it means when you are asked to give consent and a guide to questions you may want to ask of your doctor.

There is also a section on iron deficiency and anaemia and how these can sometimes be treated ahead of an operation to help prevent the need for blood transfusions.