Check before you Connect!
A recent UK Patient Safety Alert has highlighted the potential for serious harm if the incorrect administration set is used for transfusion of blood or blood components.
Use of an IV infusion set instead of a blood transfusion administration set may result in under-infusion of blood or destruction of red cells (haemolysis).
ANZSBT Administration Guidelines provide Australian guidance that covers:
Transfusion of blood and blood components
An approved blood administration set (170–200 micron filter) must be used for:
- red cells, platelets, fresh frozen plasma, cryoprecipitate, cryodepleted plasma, whole blood and granulocytes.
- when blood is being administered by syringe to small infants or neonates
- the blood must be drawn into the syringe via a 170–200 micron filter
Administration of fractionated blood products
Albumin and IV immunoglobulin formulations that do not require reconstitution may be administered via either a:
- standard IV administration set or blood administration set.
For other plasma-derived blood products
- individual product information should be consulted.
Administration from a glass bottle requires a vented system.
Use of the correct set is important because IV infusion sets and blood transfusion sets use different filters for different reasons.
- An IV infusion set contains a very small filter (pore size ~15 micron) to trap particulate matter, so it is not infused.
- A blood transfusion set contains a large filter (pore size 170 - 200 micron) to remove clots and particulate matter but allow larger blood components (such as red cells and platelets) to pass through unrestricted and undamaged.
When transfusing blood and blood components
- Always use an approved blood administration set.
- Check the filter size on the packaging (170–200 micron) before commencing.
- Familiarise yourself with blood administration sets used within your health service.
- Refer to local guidance to confirm which sets are appropriate for specific situations.
Review local storage to reduce the risk of selecting the wrong type of administration set, (including storing blood sets clearly separated from IV infusion sets).
More information
ANZSBT Guidelines for the Administration of Blood Products (section 6.2.1, page 25)
SHOT Bite No.35: Learning from SHOT administration set errors - Serious Hazards of Transfusion