Blood and blood products
National Blood Authority
While the use of blood products is now significantly safer than it was in past years, it still carries a small but real risk. The links provided below are predominantly to the National Blood Authority website which appears to have the most up to date and well evidenced material which is easily accessible.
The focus of transfusion practice is now on managing the patients problem rather than when to use blood termed "patient blood management".
Australian and New Zealand Society of Blood Transfusion
The ANZSBT publishes Guidelines for the Administration of Blood Products to provide guidance on the appropriate storage, collection and transport of blood products, as well as the safe administration of blood products and the management of transfused patients. This document should be used as a best practice reference to inform jurisdictional and health service policy and procedural documents.
Critical bleeding and massive transfusion protocols
On the NBA website and you can view or download full guidelines, rapid guidelines and also an editable template to suit your institution, they are very easy to access. With the template is a set of prompts for use when managing critically bleeding patients, these will help if you are concerned and alone but call for help. These are available at the NBA as an App.
NBA Suggested criteria for activation
- Actual or anticipated 4 units RBC in <4 hours, haemodynamically unstable +/- anticipated ongoing bleeding.
- Severe thoracic, abdominal, pelvic or multiple long bone trauma
- Major obstetric, gastrointestinal or surgical bleeding
Patient blood management
For all other patient blood management guidelines for medical, critical care, obstetric and paediatric/neonatal click here.
Use of RhD immunoglobulin
For the current recommendations for use of immunoglobulin in Rh -ve patients who are sensitised such as at miscarriage.
NSW Health Guidelines - Maternity - Rh (D) Immunoglobulin (Anti D) - GL2015_011.
Procedure for emergency treatment of patients with inherited bleeding disorders
Further References and Resources
Australian Red Cross Blood Service website - Australian Red Cross Blood Service information and education for health professionals.
Mytransfusion.com.au website - A patient website for blood transfusion, aimed particuarly at patients who may be requiring a planned transfusion.
PROPPR Trial - for trauma patients in ED.
- BloodSafe e-learning for online courses relating to clinical transfusion practice including blood specimen collection, transportation, post partum haemorrhage, iron deficiency, critical bleeding and patient blood management.
- Blood Transfusion - information for patients and families, Clinical Excellence Commission