Red blood cells are suspended in a small amount of plasma and anticoagulant

/preservative solution (AS-1, AS-3, AS-5) with an approximate total volume of

350 mL. Each RBC unit should raise the average adult's hemoglobin 1 gm/dL.

Prestorage leukoreduced red cells are used. This component provides red

cells to carry oxygen to the tissues. RBCs must be started within 30 minutes after

pickup. Infusion must be completed within four hours after issue. If needed,

divided units are available to transfuse over a longer period of time.

Clerical error is the most common cause of fatal hemolytic transfusion reactions. A major cause

of clerical error is the mislabeling of the patient's blood specimen. The phlebotomist will not

draw blood until an armband properly identifies the patient. When an unidentified patient is

admitted to the Emergency Room and laboratory work is ordered, packet containing

an armband with a medical record number should be used. If there are delays in this process

the phlebotomist may place a temporary green armband, (Typenex) with a unique number, on

the patient to facilitate swift identification. It is ESSENTIAL that this temporary armband remain

on, even after the regular band has been put on.

The individual who draws a specimen to be used for Transfusion Service

testing MUST label the tube with their initials, the patient's first and last name, the

medical record number, and the date and time drawn. Labeling must occur at the

patient's bedside.