This manual presents optimal Transfusion Medicine practice guidelines for all levels of physicians responsible for Transfusion Medicine services in BC.

 1st Edition 2007
 Table of Contents
 

The Table of Contents provides a quick reference to the manual contents.

 Glossary of Terms and Abbreviations  

The Glossary of Terms and Abbreviations provides a definition of the terms and abbreviations used in the manual

 Introduction
 

Introduction to the manual and overview of the intended audience and applicable standards.  An overview of the role and responsibilities of the TM Medical Director (or designate) is provided at the end of the module.

This section includes the title page and copyright information if the manual is printed from the pdf modules.

 Section 1.0 Medical Roles and Responsibilities
 
Section 1.0 includes policies applicable to Transfusion Medicine Medical Director (TM-MD) medical roles and responsibilities.

1.1 Policies and tables applicable to the indications for Consultation with the TM-MD or Designate by TMS Staff

 
 Section 2.0 Quality System Management
 
Section 2.0 includes policies applicable to the TM-MD and Transfusion Medicine Service (TMS) staff as related to the management of the TMS quality system.

2.1 Components of Assessment QSE

 
 Section 3.0 Informed Consent and Refusal of Consent
 
Section 3.0 includes policies applicable to the TM-MD, Transfusion Medicine Service (TMS) staff, Treating Physician, and Treating Nurse as related to the informed consent, and refusal of consent, process.
 Section 4.0 Daily Operations

Revised

July 2010

Section 4.0 includes policies applicable to the TM-MD and the Transfusion Medicine Service (TMS) staff as related to the processes and procedures that define regular, daily operations. This section was reviewed and revised in January 2009 to reflect changes in practice related to the Weakened Expression of the D-Antigen examination. The section was further revised in July 2010 as Transfusion Reaction was moved to a new section of the manual.

4.1 Patient Identification and Sample Labelling Criteria

 

4.2 Pre-transfusion Examinations

 

4.3 Inventory Management

 
 Section 5.0 Appropriate Use of Blood Components for Adults
Revised  July 2014
Section 5.0 includes policies applicable to the TM-MD and to the Transfusion Medicine Service (TMS) staff as related to the appropriate use of blood components for adults.

5.1 Transfusion of Red Cells to Adults

 

5.2 Transfusion of Platelets to Adults

 

5.3 Transfusion of Frozen Plasma to Adults

 

5.4 Transfusion of Cryosupernatant Plasma to Adults

 

5.5 Transfusion of Cryoprecipitate to Adults

 
 Section 6.0 Special Product Selection

Revised

May 2013

Section 6.0 includes policies applicable to the TM-MD and to the Transfusion Medicine Service (TMS) staff as related to the selection of special blood components.

6.1 Platelet Selection

 

6.2 Irradiation of Blood Components

Revised

Mar 2015 

6.3 Indications for Anti-CMV Negative Red Cells and Platelets

 

6.4 Indications for Washed Red Cells and Platelets

 

6.5 Indications for HLA-matched Platelets

 

6.6 Emergency Release of Red Cell Unit(s)

 Revised

Aug 2015

 Section 7.0 Appropriate Use of Other Blood Products

Revised

Jan 2009

Section 7.0 includes policies applicable to the TM-MD and to the Transfusion Medicine Service (TMS) staff as related to the appropriate use of blood products, predominantly Albumin and IVIG. This section was reviewed and revised in 2009 to include the 2007 Guidelines for Albumin Use in Adults in BC, and changes made to the IVIG Program in BC.

7.1 Appropriate Use of Plasma Fractionated Products

Revised

Aug 2015

7.1.1 Indications for the Use of Albumin

 

7.1.2 Indications for the Use of IVIG

 

7.1.3 Indications for the Use of Other Plasma Fractionated Products

 

7.2 Appropriate Use of Recombinant Products – Recombinant Factors VIIa, VIII and IX, Erythropoietin

 
 Section 8.0 Appropriate Use of Blood Products in Neonates or Pediatric Patients

Revised

Oct 2013

Section 8.0 includes policies applicable to the TM-MD and to the Transfusion Medicine Service (TMS) staff as related to the appropriate use of blood products in neonates or pediatric patients. This section was reviewed and revised in 2013 and added a clinical recommendations section for the appropriate use of blood components in neonates and infants less than 4 months of age.

8.1 Technical Recommendations for the Appropriate Use of Blood Components in Neonates and Infants Less than 4 Months of Age

Revised

Jun 2015

8.2 Clinical Recommendations for the Appropriate Use of Blood Components in Neonates and Infants Less than 4 Months of Age

Revised

Jun 2015

8.3 Pediatric Blood Product Transfusion

 

8.4 Transfusion of Frozen Plasma to a Pediatric Patient

 

8.5 Management of Congenital Hemolytic Anemias

 

8.6 Transfusion Management of Autoimmune Hemolytic Anemias in Pediatric Patient

(See Section 9.3: Transfusion Management of Autoimmune Hemolytic Anemia)

 
 Section 9.0 Special Transfusion Scenarios
 
Section 9.0 includes policies applicable to the TM-MD and to the Transfusion Medicine Service (TMS) staff as related to special transfusion scenarios.

9.1 Support of a Patient with Signed Refusal of Consent for Transfusion

 

9.2 Management of Patient requiring Massive Transfusion

 

9.2.1 Switching ABO group in Massive Transfusion or During Inventory Shortage

 

9.2.2 Switching from D-negative to D-positive in Massive Transfusion

 

9.2.3 Massive Transfusion in Recipient with Alloantibodies

 

9.3 Transfusion Management of Autoimmune Hemolytic Anemia

 

9.4 Transfusion Support of Minor Incompatible Solid Organ Transplant Recipients

 

9.5 Transfusion Support of Allogeneic Stem Cell and Bone Marrow Transplant Recipients

 

9.6 Recommendations for Red Blood Cell Unit Selection and Phenotype Matching for Transfusion Support of Sickle Cell Disease

 Revised

Jun 2015

 Section 10.0 Disaster Plans
 
Section 10.0 includes policies applicable to the TM-MD and to the Transfusion Medicine Service (TMS) staff as related to the development and implementation of disaster plans that may be specific to the TMS, or broaden out to include the Health Authority.
 Section 11.0 Transfusion Reactions

Revised

Oct 2014

Section 11.0 includes policies applicable to the TM-MD and to the Transfusion Medicine Service (TMS) staff as related to the identification, investigation and management of transfusion reactions.

TMS IVIG Request Process