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Procedure for the Urgent issue of Blood Products and Major Haemorrhage

In an emergency, requests can be made by telephone but a request form must also sent to the Blood Bank. The Blood Transfusion staff will then give an indication on the products that would be available and the time scale.


Contacting the Laboratory in an Emergency

During the core working day - Monday to Friday, 8.45am to 8.00pm - the Blood Bank can be contacted by phone via extension 2628.

Outside of these hours – please bleep 205, to reach a Biomedical Scientist for haematology.

Major Haemorrhage Protocol activation – 6181 (strictly for major haemorrhage activation only).

Urgent Group and Save Samples

The Blood Bank should be informed directly regarding urgent samples by phone or bleep 205 (out of hours). The request form should then be labelled “urgent” with an indication of the time and date that blood is required for or when a patient is due for a procedure. The term “ASAP” does not help the laboratory staff to determine priorities.

If transfusion samples are deemed urgent the clinical area is required to inform the laboratory via bleep 205. The laboratory staff taking the call will then document this information on the ‘Blood Transfusion Urgent Sample Receipt Log’. Urgent Transfusion samples are to be hand-delivered and the handover documented on the BT urgent sample receipt log to ensure accurate audit and prevent delay in sample processing. Delay is more likely out-of-hours when samples are delivered to the laboratory but the biomedical scientists are unaware of this delivery.

Life-threatening haemorrhage – Immediate Transfusion

In an emergency situation where the patient is likely to die from exsanguination before blood can be cross matched, Group O blood can be given until the patient’s blood group is established. This is purely at the discretion of the clinician looking after care of the patient and should only be utilised in life-threatening scenarios where groups specific compatible blood cannot wait to be issued.

Depending on  patient circumstances, group O Rh D Negative or Positive blood can be given. Blood grouping should be carried out as quickly as possible to minimise the ‘blind’ use of group O blood, and this should be limited to no more than two units in most instances. Once the patient’s blood group has been determined and the two sample rule criteria is fulfilled, a switch to group specific blood should be made.

There are times 2 units of O Rh D Negative and times 2 units of O Rh D Positive ‘Flying Squad’ red cells available at all times in the blood issue fridge. Each unit is identified by colour coded and symbol driven identification tags to guide staff in selecting the appropriate unit of blood for particular patients described below.

A graphic explaining gender considerations for blood transfusions

O Rh D Negative Units suitable for flying squad should be K Negative, CMV Negative. There are no special requirements for O Rh D positive emergency red cells.

In addition, 1 unit of O Rh D Negative paediatric flying squad blood is also stored on the top of the stock fridge. In the rare event of a newborn resuscitation, this unit must be issued immediately on request in a cool box.

It is no longer a requirement to issue HT negative red cells for use as flying squad units.

Emergency blood

Emergency blood will only be supplied at the request of medical professionals who will liaise with the Blood Bank, and accept full responsibility for un-cross matched blood issues. Blood will either be group O or type specific depending upon the degree of urgency. 

Flying squad Group O blood can be found on the top shelf of the blood issue fridge.

Major Haemorrhage Protocol

Full Trust guidance and protocol for the Haematological Management of Major Haemorrhage can be found here.

This webpage was reviewed and updated by Mark Taplin, Blood Transfusion Manager, 22nd February 2024