Major Blood Haemorrhage Protocol
Major Blood Haemorrhage Protocol
Rationale for Training
Major blood hemorrhage is a critical condition, mainly common among people with obstetric cases and other forms of traumas. Therefore, the principal or massive hemorrhage protocol plays a critical role in promoting confidence and teamwork among blood porters and other clinical staff when responding to a crisis and emergencies concerning significant hemorrhage. The protocol, however, promotes effective communication and teamwork between the blood bank and clinical area and provides adequate transportation of blood components to patients with significant bleeding.
On the other hand, the protocol prevents errors that occur during the administration of blood, and its components can be highly hazardous to patients. From past reports emanating from the blood transfusion laboratories, more than a hundred instances of blood transfused to the wrong patients each year have been recorded. These errors have led to the death of patients and the emergence of health issues associated with ABO-incompatible transfusion to patients suffering from a major hemorrhage. Patients going through major hemorrhage require multiple blood transfusions and support since the patients lose twenty percent of blood within an hour and fifty percent of blood within the first two hours. The common errors that occur during the collection of blood samples for theatre require porters and pre-transfusion compatibility testing include:
Failure to issue the patient’s identification number shows the patient’s contact with the hospital. Failure of the doctor to use the identification wristbands.
Mistaken patient identification leads to mistaken identity; hence blood is transfused to the wrong person.
The use of other alternative identifiers, such as hospital notes and request forms
Sample labeling errors take place when the doctor fails to label the sample tube.
Blood bank records errors such as failure to check the previous patients’ records for particular blood components and blood groups.
Telephone request errors such as failing to ask for the identification number o the type f blood component needed.
Having adequate knowledge and policies for the safe collection of blood components for theater porters is critical in saving lives.
The information provided targets blood porters, midwives, nurses, hospital blood bank laboratory staff, and other medical professionals handling patients’ blood samples or responding to patients with major blood haemorrhage.
Aims and Objectives
The workbook aims at providing knowledge and guidelines concerning safe collection of blood components for theater porters, aiming at responding to patients with significant bleeding. The collection of wrong blood components is a common problem when blood porters fail to check for identity with the patients. The main issue originates when blood components are not identified with patients when handed from blood bank staff to blood porters. This primary hemorrhage protocol will ensure that the health organization follows the Blood Safety and Quality Regulations of 2005, focusing on the quality and safety for the collection, testing, processing, storage, and distribution of human blood components. To patients going through significant hemorrhage.
The primary hemorrhage protocol enlightens blood porters and other medical staff concerning information required by a blood bank to release blood components for the patient. Some of the critical information required includes contact number, patient’s diagnosis, the urgency of the situation, and any cross-match with the available blood type. From the existing regulations, every clinical staff dealing with blood must ensure every unit of blood is collected through documented evidence and with a competency assessment and up-to-date training assessment. Furthermore, the workbook aims to enlighten the clinical staff about the adverse Severe Blood Reaction and Events (SABRE). Every unit of blood must be traced from the donor to recipient before collection and records of activity stored for thirty years.
The major haemorrhage protocol/workbook also aims at ensuring that clinical staff can use the pottering services when collecting blood components and check any blood component of arrival to the theater. If the porter wants to return the collected blood component to the laboratory, the clinical staff should sign a receipt. According to (SHOT), the information provided aims at enlightening clinical staff about the need for a final bedside check before blood administration to prevent incorrect blood transfusion. During collection, the clinical staff should ensure that the blood component has no evidence of blood infection, which s mostly noted through the presence of gaseous bubbles, turbidity, blood clots, or color. The workbook ensures clinical staff learns about SHOT requirements, safe collection of blood, the importance of the safe collection, and the best procedure for blood component collection.
Butwick and Goodnough (2015) is an article that discusses transfusion and coagulation management in major obstetric hemorrhages. The article further explains how major hemorrhage is the leading cause of death among many people, especially in women, due to postpartum hemorrhage (PPH). Furthermore, the article discusses suitable and effective ways of providing safe blood to patients suffering from significant bleeding, such as massive transfusion protocol(MTP) that ensure blood is available in case of severe postpartum hemorrhage. On the other hand, the article discusses blood ordering and massive transfusion protocol for postpartum hemorrhage, which entails blood transfusion therapy (Butwick and Goodnough (2015). The model, however, is effective, especially when it comes to sufficient blood volume and faster transfusion of blood, hence saving lives in emergency cases.
Bialkower, and Garnier (2020), is an article that discusses fibrinogen diagnostics in significant bleeding. According to the article, patients with hypofibrinogenemia are at a higher risk of suffering from significant bleeding, which is a condition that is diagnosed when a person has low levels of fibrinogen (Bialkower, and Garnier, 2020). The article, however, discusses the role of significant hemorrhage protocol(MHP), especially its psychological role in fibrinogen. Yeh, et, al., 2020) is another article that discusses the development of a standardized provincial massive hemorrhage protocol with a built-in continuous quality improvement. According to the article, the MHP encourages evidence-based practice and a way for continuous Q1.
Assessment of Theoretical knowledge
According to directives 2005/62/EC. Blood components should be evaluated regularly. However, the assessment process assists in measuring and evaluating achievements made from the significant hemorrhage protocol. The assessment process targets and evaluates clinical staff’s progress and the application of knowledge provided to perform several tasks, such as collecting blood in response to a significant hemorrhage patient. The e-learning program is used to assess knowledge learned from the training. The assessment process evaluates knowledge concerning the delivery of blood to a hemorrhaging patient. According to the training, blood must be checked before collection and transported in boxes that are verified. Any withdraw of a blood component from the refrigerator should be documented. After being delivered in the operating theater, the porters and clinical staff should check whether the blood is the correct one.
A background knowledge test, actual/false questions, checklist evaluation, live simulation, direct observation of practice, and videotaping a practice session are some of the assessment methods used to test the ability of blood porters and other clinical staff to apply the knowledge acquired through training. The clinical staff first should receive an induction program, which is significant for medical professionals, such as nurses, porters, staff, hospital blood bank laboratory staff, and other staff involved in responding to significant hemorrhage cases and blood transfusion processes.
Additionally, through knowledge acquired, staff are assessed using an observation process, where a collection of blood components is observed. The staff is provided with risk management programs and a questionnaire administered to determine staff’s knowledge concerning transfusion policies. The questionnaire assesses the ability of staff to apply policies and collection procedures according to facility standards. In addition, the staff’s knowledge of information technology plays a vital role in the administration of blood and safety procedures, for instance, the use of bar code labeling, hand-held scanners for patients identification, which plays a vital role in the collection of blood components.
Bialkower, M., & Garnier, G. (2020). Fibrinogen Diagnostics in Major Hemorrhage. Critical Reviews in Analytical Chemistry, 1-16.
Butwick, A. J., & Goodnough, L. T. (2015). Transfusion and coagulation management in major obstetric hemorrhage. Current opinion in anaesthesiology, 28(3), 275.
Yeh, C., Cope, S., Thompson, T., McGilvray, S., Petrosoniak, A., Chin, V., … & Callum, J. (2020). LO41: The development of a standardized provincial massive hemorrhage protocol with a built-in continuous quality improvement framework. Canadian Journal of Emergency Medicine, 22(S1), S21-S22.