Hospitals & Science

Requests for investigation of Adverse Events & Reactions
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Summary of actions for Transfusion Laboratory staff

All adverse reactions & events, including those suspected of being the result of bacterial contamination of a component must be notified immediately to the hospital blood transfusion laboratory (TL). The laboratory must document the patient involved, the type of reaction or event, the reason for transfusion, the implicated component (including donation number), and the contact details of the clinical staff looking after the patient.

Advice on clinical management and investigation of serious adverse reactions should be obtained from your hospital consultant responsible for blood transfusion.

The NHSBT duty consultant for patients must be informed at once of serious adverse reactions to transfusion that require investigation or involvement by the NHSBT. This is particularly important in cases of suspected bacterial contamination because other components may need recall. The NHSBT consultant is reached by contacting your local NHSBT Issue Department.

Please refer to the relevant request form for minimum sample requirements for the investigation of Allo & Autoantibodies, Haemolytic Transfusion Reactions, IgA Deficiency, Transfusion Related Acute Lung Injury (TRALI), Transfusion-Associated Graft-versus-Host Disease (TA-GvHD), Post Transfusion Purpura (PTP), Febrile Non-Haemolytic Transfusion Reaction etc. (For details of request forms please see below).

A serious adverse reaction notification report must be made as soon as possible via SABRE, to both MHRA and SHOT.
 

Cases of suspected bacterial contamination

Blood cultures must be taken from the patient as soon as possible and before any (additional) antibiotics are given.

The hospital blood transfusion laboratory must contact an NBS duty consultant for patients. Please see point 3 above.

The hospital blood transfusion laboratory must return the pack to the Issue Department at the local NBS centre. An NBS microbiology request form (reference number FRM/DDR/TM/035 obtained from the website click here) must be completed and accompany the returned component. These will then be forwarded to the NBS National Bacteriology Laboratory.

The returned unit(s) must be adequately sealed with appropriate pack closure to prevent leakage and contamination. The unit(s) and any attachments must be suitably bagged, before being placed in the cool box provided and sent to the NBS. Unit(s) should be stored and transported at 4°C.

Please ring your local Issue Department to confirm that they will provide a blue porter box, on the next routine delivery, for the return of the unit(s) to the NBS.

If clinically indicated, the pack may be investigated in the local microbiology laboratory prior to dispatching to the NBS. Please contact the NBS National Bacteriology Laboratory (see contact details below) to obtain coupler spikes for sterile sampling of the unit.

The NBS National Bacteriology Laboratory must be informed of the results of blood cultures on the patient and any local cultures done on the pack. Phone number 0208 258 2959 / 2962 and ask to speak to a senior member of staff on the blood components section, or by email tti@nbs.nhs.uk
 

Request forms for investigation of Adverse Events & Reactions:

Red Cell Immunohaematology 1A
For the investigation of Allo & Autoantibodies, Haemolytic Transfusion Reaction, Haemolytic Disease of the Newborn, Autoimmune Haemolytic Anaemia and IgA Deficiency.

Histocompatibility & Immunogenetics 3A
For the investigation of TRALI, TA-GvHD, PTP, Non-Haemolytic Febrile Transfusion Reaction (NHFTR), Autoimmune Neutropenia, Neonatal Alloimmune Neutropenia, Drug Related Neutropenia etc.

Microbiology Request Form FRM/DDR/TM/035
For the bacterial investigation of components. This request is available via the website: click here.

Sample requirements
Please see for minimum sample requirements at the reverse of the RCI and H&I request forms.

Labelling and packaging
The sample labelling policy and packaging requirements can be accessed via the website and applies to all samples sent to the NHSBT click here.
For suspected bacterial contaminated units the local Issue Department will provide a blue cool box for the return of the unit(s) to the NBS.

Ordering of request forms
The request form for Red Cell Immunohaematology can be ordered from your local Issue Department.
Histocompatibility & Immunogenetics request forms are available to download click here or for printed copies please contact your local H&I laboratory by telephone.
The Microbiology request form is obtained via the website. Please click here for printable PDF.
 

Guidelines for investigation of Adverse Events & Reactions: