1. New policy starts 5th April 2016 IMPORTANT CHANGE TO BLOOD TRANSFUSION SAMPLE REQUIREMENTS Confirmation of a blood group from two samples taken on separate occasions will be a requirement before non-urgent transfusions An additional sample may be requested by Blood Bank if the patient’s blood group is not already on record

2. Origin of Policy Change BCSH (British Committee for Standards in Haematology) 2012 Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories: second check sample “Unless secure electronic patient identification systems are in place, a second sample should be requested for confirmation of the ABO group of a first time patient prior to transfusion, where this does not impede the delivery of urgent red cells or other components.” http://www.bcshguidelines.com/4_HAEMATOLOGY_G UIDELINES.html?dtype=Transfusion&dpage=0&sspag e=0&ipage=0#gl Also recommended by: –Serious Hazards of Transfusion (SHOT) –Scottish Clinical Transfusion Advisory Committee

3. Where can I find more information? Details on intranet at: Healthcare > A-Z > Blood Transfusion > Blood Component Transfusion Guidance & Indications > Blood Group Check Requirement Change for Blood Transfusion April 2016 Or via this link: http://intranet.lothian.scot.nhs.uk/NHSLothian/Healthcare/A- Z/Laboratories/BloodTrans/Component%20Transfusion%20Guidance%20a nd%20Indications/Documents/Blood%20Group%20Check%20Requirement %20Change%20for%20Blood%20Transfusion%20April%202016.pdf

4. Elective / Non Urgent Transfusions Key Points The principle of the new policy is to perform a safety check between blood groups on two separate samples. Therefore: The two samples must not originate from the same venepuncture event The two samples need to be taken on two separate occasions (no set minimum time between) In many cases the lab will already have a historical record of a patient’s group The policy is not about routinely taking two samples – it is about being aware that you may need to send an additional sample if and when the laboratory informs the clinical area that this is required The lab will call the clinical area to request an additional sample (if there is no previous record in the lab) in these circumstances: A crossmatch request is made A pre-op group and screen sample is sent from a ward or on day of surgery (the lab will not make a call for samples taken at pre-assessment clinic) Please make sure contact details are on request form and ensure messages are passed on to the appropriate person if the lab calls to request another sample This policy applies to patients over 5 years of age (paediatric arrangements under review by SNBTS) On WGH & SJH sites transfusion sample results are available in TRAK so You can see if the lab have received a sample before (since Nov 2015) If sample is the first ever processed there will be a comment attached to the result to inform that another sample would be needed before transfusion

5. Emergency and Urgent Transfusion Key Points Emergency Transfusions: Major haemorrhage events will be managed as at present (i.e. O- RCC issued if no previous sample; group specific blood issued as soon as urgent blood sample processed) Urgent Transfusions: If the transfusion lab have no historical blood group for a patient but blood is required urgently, and the requesting clinician identifies that there is not enough time to send an additional sample, the lab will issue blood on a single sample (and will request that a further sample is sent asap)