Whole Blood

Component Description

Whole Blood

Blood collected into bag with anticoagulant and not processed any further.
Stored in a monitored blood refrigerator (2 - 6º) with a shelf life of up to 35 days.

Fresh Unrefrigerated Whole Blood

Blood collected into a bag with anticoagulant and not processed any further
Unrefrigerated (20 - 24º) with a shelf life of 24 hours.

Not available from all ARCBS centres and requires specific request.

Indications For Use

• Limited indications
• Symptomatic oxygen carrying deficit AND hypovolaemic shock
• Components such as red cells and FFP are usually used in preference to whole blood
• Fresh unrefrigerated whole blood may be useful in massive transfusion; however there is little data to support its use. Please refer to your own institutional policy and to your local ARCBS regarding this form of whole blood.

Precautions

• Consider the cause of anaemia. Is a transfusion required?
• Treat haematinic deficiency (e.g. iron. vitamin B12 or folate) anaemia with supplements. Consider transfusion when condition is unstable
• Caution is needed with volume.

Dosage and Administration

• One unit (one bag) of whole blood is approximately 450mL
• One unit raises an adult patient's Hb by approximately 10g/L.

Note: this is a guide only – individual hospital guidelines should be followed.

• Administer through a new IV blood giving set incorporating a 170-200 micron filter (large particle filter which only removes aggregates and other large particles)
• For blood requiring bedside leucodepletion, a white cell filter is required. These filters are designed to remove small particles such as white cells but allow red cells, platelets and proteins to go through. Specific set-up is required – see product inserts and talk to your local Transfusion/Haematology Nurse Consultant or Transfusion Service provider. Do not ‘flush’ these filters after use.
• Units labelled as leucodepleted product do not require a white cell filter at the bedside BUT still require a standard blood administration set incorporating a 170-200 micron filter (see above).

Patient Monitoring

• Start transfusion within 30 minutes of removing whole blood from the fridge
• Check patient vital signs (pulse rate, respiration rate, blood pressure and temperature) at the start of transfusion AND at least after 15 minutes, at the end of the transfusion AND if there is ANY reaction. Record observation in patient’s notes.

• Plan ALL transfusions during business hours. Emergency transfusions should be the only transfusions given after hours.
• Transfuse ONE unit at a time.

• Generally 2 – 4 hours
• Each unit must be transfused within four hours of starting
• May be given faster in acute bleeding situations
• Consider using a blood warmer for massive transfusion situations.