Neobook — clinical reference

Determination of the Rh type of the patient

The Group O blood in the emergency blood fridge is indicated for use in dire emergencies only – when there is insufficient time to request crossmatched blood from the blood bank.

Care and maintenance

The hospital will designate staff (usually nurses) to monitor the stock levels and the checks (e.g. for temperature and alarm) that need to be done twice a day (once per shift).

Stock can be replenished on any day by requesting blood (on the appropriate documentation) from the blood bank. Requests should preferably be made one day in advance to ensure that blood bank can supply Group O blood on time.

Order blood when your stock is at 50% to prevent having an empty fridge when another emergency arises.

Daily checks include:

Visual checks for colour changes and damage to the packs and the fridge.
Units stored in group and expiry-date order.
Units cabled tied onto the grid.
Stock levels checked and stock ordered from blood bank.
Correct storage temperature of between 2ºC and 6ºC.
Only Anti-D Kit and emergency blood stock kept in fridge.
Fridge is connected to an uninterrupted power supply.

Discrepancies must be reported to the blood bank immediately.

Power failure

In case of power failures, please inform the blood bank if the power is not restored within 10 minutes so that arrangements can be made to move the blood to alternative appropriate storage with a temperature of between 2ºC and 6ºC (e.g. cooler box or other fridge).

Alarms

The alarm button can be silenced by pushing the button, but will continue to sound again every 30 minutes until the causative factor has been attended to. Switching the fridge off does not deactivate the alarm. Please inform the blood bank if a problem cannot be rectified.

Determination of the Rh type of the patient

Some emergency blood fridges stock only Group O-negative units and thus no RhD test is needed as Group O-negative units are compatible with all other blood groups.

There are emergency blood fridges which have Group O-positive and Group O-negative units and a RhD test must therefore be performed on the patient’s blood specimen prior to selecting a unit for transfusion. Rh should be determined on all patients, so that O-positive patients can receive O-positive emergency blood, thus preserving the very scarce O-negative stock.

Selection of unit for transfusion

Rh-positive for Rh-positive patients.

Rh-negative for Rh-negative patients.

If Rh test is in doubt or if patient is of childbearing age, use Rh-negative blood.

Check the unit prior to removal for clots, clumps, colour changes and damage.

Documentation

Record patient and blood pack details on “THE STOCK BLOOD / PLASMA INFUSION RECORD” form attached to the emergency unit it the fridge and return to blood bank as soon as possible. This is a legal requirement according to the National Health Act.

Navigation to a Safe Blood Transfusion - Updated August 2023