REMEDY : BNSSG referral pathways

Blood Tranfusions

Checked: 08-10-2018 by vicky.ryan Next Review: 08-10-2019

Blood Tranfusions - General advice

Blood transfusions may be required in patients with severe anaemia or symptomatic anaemia.

As a guide NBT advise the following:

Requests for blood transfusions should be considered in patients with:

Hb < 70g/l

or

Hb < 80g/l with history of cardiovascular disease or with symptoms e.g. chest pain, breathlessness, hypotension, tachycardia, cardiac failure. (consider discussion with GPSU if immediate concerns).

Requests for transfusions should be made directly to the appropriate day unit (see referral section below) except in the following patients:

Oncology patients requiring transfusion should be discussed with the appropriate oncology team or via the on call oncologist.

Renal patients requiring transfusion should be discussed with the renal team at Southmead hospital.

 

Iron Infusions

For patients with iron deficiency anaemia iron infusion may be more appropriate and referrals can be made to either UHB or NBT. Please see anaemia section in gastroenterology chapter of Remedy for details on how to refer.

Referral

UHB - Referrals for a blood transfusion at UHB should be made directly to the Ambulatory Care Unit via email: ubh-tr.PathClinic@nhs.net (Fax referrals are no longer accepted). If advice is required then please call the ACU on 0117 3424363.

NBT - Referrals for a blood transfusion at NBT should be made via fax to the Medical Day Unit on 0117 414 9484 or email : MedicalDayCare@nbt.nhs.uk with [ENCRYPT] as the first word on the “subject” line of the email.. If advice is required then please call the Day Unit on 0117 4143205 or 0117 414 3206. Please use their proforma and pathway when referring - referrals sent without a proforma will be rejected.

 

Referrals should include:

  • Patient contact details.
  • The diagnosis/ cause of anaemia.
  • Recent FBC and ferritin (within last week).
  • List of symptoms and examination findings.

All referrals are triaged and then the patient contacted by the hospital to arrange the transfusion. Cross matches should be done within 48 hours of the planned transfusion and must be correctly labelled.

 

Community IV Service NSCP

 NSCP are able to provide Blood Transfusions in the community.

Clinical guidance on when a patient is suitable for blood transfusion is available via NBT: https://www.nbt.nhs.uk/sites/default/files/Clinical%20Indications%20for%20Transfusion.pdf NBT will be providing the lab services, support and blood.

Additionally for a patient to receive a blood transfusion in the community, the patient should have had:

  •  At least one transfusion in the acute setting with no severe reactions
  • Two previous group and antibody screen tests (UHBristol, WGH or NBT).

 The NSCP Blood Transfusion Patient Specific Direction form is available, in North Somerset GP Practices, as an EMIS template