FFinalistSouthampton · 2027
All procedures
GMC #24/Therapeutic procedures taught E-learning + from Y3

Safe & appropriate blood transfusion

Understand safe transfusion practice and be able to discuss it with a doctor. Assessed as TWO sign-offs — the e-learning and a professional conversation — not by administering blood.

Target · Simulation only0% ready

Practise in a simulated setting; further training needed before doing it on a patient (GMC “simulation”).

Overview

Assessed as two separate sign-offs, one each: · 24a — Blood Transfusion e-Learning for doctors and non-medical authorisers of blood components. · 24b — Blood transfusion professional conversation, discussed with a relevant doctor. There is no simulated administration to be signed off, which is what this page previously implied. The knowledge below is what the conversation covers, and the dominant theme is patient safety — the bedside identity check is what prevents the catastrophic ABO-incompatible (“wrong blood in patient”) reaction.

Key numbers

  • Transfusion threshold 70 g/L (target 70–90 g/L); 80 g/L in acute coronary syndromeNICE NG24
  • Start a unit within 30 min of leaving the fridge; complete within 4 hoursBSH / local policy
  • Observations: before, at 15 min, then per policy, and at completionBSH

Indications

  • Symptomatic anaemia — restrictive threshold 70 g/L (target 70–90 g/L after), or 80 g/L in acute coronary syndrome
  • Major haemorrhage

Contraindications & cautions

  • Only transfuse if clinically indicated; consider iron/alternatives; use restrictive thresholds

Equipment

Valid group & save / crossmatched componentBlood-administration giving set (integral filter)Prescription, observation chart

Step by step

Prepare
  1. 1Ensure a valid sample & prescription; gain consent; take baseline observations
  2. 2Ensure IV access (green/pink cannula) is patent
The bedside check (critical)
  1. 1Positively identify the patient — ask them to state name & DOB
  2. 2Two-person check: patient wristband ↔ compatibility label ↔ the unit (blood group, donation number, expiry)
  3. 3Any discrepancy → do not transfuse
Transfuse & monitor
  1. 1Start slowly; observations at 15 minutes, then per policy, and at the end
  2. 2Complete each unit within 4 hours of leaving the fridge
  3. 3Watch for a reaction — fever, rigors, hypotension, breathlessness, loin/chest pain
Reactions
  1. 1Stop the transfusion, maintain IV access, ABCDE, re-check identity/unit
  2. 2Escalate; distinguish acute haemolytic (ABO) / TACO / TRALI / febrile / allergic-anaphylactic

Complications

  • Acute haemolytic (ABO incompatibility), febrile non-haemolytic, allergic/anaphylaxis, TACO (overload), TRALI, bacterial contamination, delayed haemolysis

OSCE tips

  • The bedside positive-ID check is the exam’s core safety point — never skip it.
  • Unit up within 30 min of leaving the fridge; finished within 4 hours.
  • Know the reaction types and the immediate “stop + ABCDE + escalate” response.

Read

Blood transfusion e-learning (e-LfH)e-Learning for Healthcare
Blood transfusion reactions — overviewGeeky Medics

Sources & credits

Authored to UK finals standard and verified against UK guidance (NICE NG24 · BSH) and Geeky Medics OSCE guides . Southampton teaching materials © University of Southampton. Always follow current local policy.