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The clinical indications for transfusion in neonates and infants may differ from those for adults, as infants are more susceptible to some of the harmful effects of transfusion. For the purpose of these guidelines, neonates are considered to be babies within 4 weeks of their normal gestational age. Infants are babies within the first year of life. Most neonatal paediatric transfusions are small volume, given to replace the blood losses of investigative sampling or to alleviate the anaemia of prematurity. Larger transfusions are needed for replacement during surgery or pathological blood loss. Replacement in excess of blood volume may occur during cardiac bypass surgery or total blood volume exchange.
Menorrhagia and Inherited Bleeding Disorders Women bleed – and this is especially so in childbearing years where menstruation
Classic haemophilia is an X-linked disorder, with either a deficiency of factor VIII (haemophilia A), or of factor IX (haemophilia B) being inherited from the mother. Factor VIII and IX, together with phospholipid, form the "tenase" complex which converts factor X to its active form Xa; deficiency of one is clinically indistinguishable from the other, and the diagnosis is made on specific assays and blood levels. This level also serves to categorise the severity, with a factor level of < 1% being severe, 1 - 5% moderate and 5 - 25% mild. The severe and moderately affected individuals are prone to spontaneous bleeding - usually in joints – for which most patients are on home factor replacement therapy. They may, however, also present with spontaneous life threatening bleeds; inappropriate iatrogenic intervention may also be responsible for this situation. For this reason, the emergency poster (Fig. 1) has been prepared and will be widely distributed to emergency units.
These guidelines are established to ensure safe transfusion of all blood products. Red Cell Products
These units will be kept for a further 24 hours for the same patient.
The Transportation of Blood and Blood Products All blood and blood products are handled, stored and transported under optimum conditions to prevent damage and deterioration. Before despatch from our headquarters, the temperature of all blood products is recorded. A temperature record is again taken on arrival at the Blood Banks. These records are kept for purposes of quality assurance and traceability. Appropriate containers and eutectic devices are used, to ensure that optimum temperatures are maintained across all links in the transfusion process – from collection, to processing, to distribution to the blood banks, and subsequently to the hospitals and patients. |
Menorrhagia and Inherited Bleeding Disorders Haemophilia Emergencies |
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