Single unit blood transfusions

This page contains information for clinical and laboratory transfusion staff to support a single unit approach to blood transfusion

PBM strategies are paramount to optimize patients own red cells and avoid transfusion where possible. However, where transfusion is unavoidable, restrictive Hb thresholds and a single unit approach should be adopted for non- bleeding, stable patients and those not on a chronic transfusion programme.

Transfusing one unit at a time minimises inappropriate transfusion thereby minimizing any serious risks associated with transfusion such as TACO.

Guidance

Resources

Examples of good practice

In 2018 the PBM Team ran a number of projects with the hospitals below, and developed resources which may help other hospitals to implement a single use policy.

This follows our 2014 pilot project with Kings College Hospital, to introduce a single unit transfusion policy for non-bleeding medical patients in an acute medical unit which resulted in a 40 - 45% reduction in red cell use over a 6 month period.

Royal Derby Hospital

Appropriate red cell use in adults

Summary and report on empowering lab staff to improve the appropriate use of red cells in adults

Infographics

Recommendations

The Patient Blood Management (PBM) recommendations endorsed by NHS England state (2014):

'Transfuse one dose of blood component at a time e.g. one unit of red cells or platelets in non-bleeding patients and reassess the patient clinically and with a further blood count to determine if further transfusion is needed.'

The British Society for Haematology (BSH) administration guidelines 2017 and NICE Blood Transfusion guideline (NG24) 2015 support a single unit transfusion approach.

Single unit transfusion applies to stable, normovolaemic adult in-patients who do not have evidence of clinically significant bleeding.

If you would like more information, please contact your Patient Blood Management Practitioner.