Blood Transfusion Consent 🩸

• A blood transfusion is when blood from a screened donor is given through a vein.
• It is a common, safe procedure that can be life-saving.
• Per HSE guidance, a transfusion may replace blood you have lost or specific blood components such as red blood cells, plasma, or platelets.

• Anaemia (lack of red blood cells).
• Conditions affecting red blood cells, such as sickle cell disease or thalassaemia.
• Cancer or cancer treatment affecting blood cells, such as chemotherapy or stem cell transplants.
• Severe bleeding, usually from surgery, childbirth, or a serious accident.
• If the patient is unsure why transfusion is recommended, explain the indication clearly before proceeding.

• Explain the procedure and obtain consent before transfusion; a consent form is usually required.
• Take a blood sample to confirm blood group before transfusion.
• The patient will only receive blood that is safe for their blood group.
• Check full name and date of birth match the blood form, wristband, and patient.
• Ask whether they have had a previous transfusion reaction or special transfusion needs (e.g. irradiated blood for Transfusion Associated Graft-versus-Host Disease risk).
• Document verbal or written consent according to local hospital policy.

• The patient sits or lies in a chair or bed.
• A needle is inserted into a vein in the arm or hand and connected to a bag of blood.
• Blood runs through the tubing into the vein.
• One unit can take up to 4 hours, but is often faster.
• Patients can usually go home soon afterwards unless seriously unwell or multiple units were given.

• The patient may feel a sharp prick when the needle is inserted but should not feel anything during the transfusion itself.
• Check observations regularly while blood is running.
• Stop and assess if the patient feels unwell or uncomfortable.
• Some patients develop temperature, chills, or a rash — usually treated with paracetamol or by slowing the transfusion.
• Mild arm bruising or ache for a few days afterwards is common.
• Advise the patient to contact their GP if they feel unwell within 24 hours, especially with breathlessness or chest or back pain.

• Blood transfusions are common and generally safe.
• All donor blood is screened for serious infections such as hepatitis, syphilis, and HIV.
• A sample of the patient's blood is also checked to ensure it matches the donor blood.
• There is a very small risk of complications, including allergic reaction or problems affecting the heart, lungs, or immune system.
• Per HSE figures: risk of hepatitis C is about 1 in 12 million donations; risk of HIV is about 1 in 9 million donations.
• Risks should normally be explained before transfusion. In emergencies this may not always be possible — discuss afterwards if needed.

• A transfusion is only recommended when needed and when other treatments will not help.
• If transfusion, anaemia, or surgery is anticipated, medicines may be used to lower bleeding risk or boost red blood cell numbers.
• These can reduce the chance of needing a transfusion.
• If the patient refuses transfusion, they may be at greater risk of anaemia — discuss with the consultant before planned surgery or pregnancy.

• "Where does the blood come from?" — From carefully screened voluntary donors via the Irish Blood Transfusion Service (IBTS).
• "Can I get an infection from this?" — Very unlikely due to screening, but the risk is not zero.
• "What happens if I have a reaction?" — The transfusion is stopped immediately and supportive treatment is given as needed.
• "Are there alternatives?" — Sometimes medicines to reduce bleeding risk or raise red cell count; discuss with the treating team.
• "Can I give blood afterwards?" — No. Patients cannot donate blood after receiving a transfusion (vCJD safety measure).

• Some patients decline transfusion on religious or personal grounds — discuss clearly, document the decision, and involve senior support early.
• In emergency bleeding, full consent discussion may not be possible; explain and document as soon as practicable.
• IBTS and hospitals must retain donor and transfusion records, including personal records, for 30 years.
• Offer interpreter support if there is a language barrier.
• HSE provides blood transfusion patient information online. For UK practice, offer the NHS Blood and Transplant Receiving a blood transfusion leaflet, with JPAC translations when needed.

• "We are recommending a blood transfusion because [indication]. This means giving you blood from a carefully screened donor through a drip into your vein."
• "Before we start, we will take a blood sample to check your blood group and make sure you receive blood that is safe for you."
• "Most people tolerate transfusions well. We will monitor you closely throughout. Some people get a temperature, chills, or a rash, which we can usually treat quickly."
• "Serious reactions and infections are very rare, but they are not impossible — that is why we check your details carefully and monitor you during the transfusion."
• "There may be alternatives such as medicines to help your blood count, but in your situation a transfusion is the best option."
• "Do you have any questions, or is there anything you would like me to clarify before we proceed?"

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