Definition and Overview
A blood transfusion consultation is an appointment with a doctor, such as a hematologist, before the procedure is performed.
Blood is one of the most important fluids in the body. It's different kinds play a variety of significant roles for a person’s survival. These are:
- Red blood cells, which are necessary to bring oxygen to other cells where it is used for different metabolic functions
- White blood cells, which act as soldiers, protecting the body from pathogens
- Platelets, which control bleeding to avoid massive blood loss
- Plasma, which works with platelets
The body requires a certain amount of blood to work properly. Situations that result in an adequate amount of blood can lead to life-threatening complications including death.
In many cases, blood transfusions are not the immediate or first line of treatment. Normally, medications, which help increase blood production or slow down bleeding, are provided. But in times when they might be needed, a consultation may happen before the procedure.
Who Should Undergo and Expected Results
A consultation may be performed if:
The patient requires multiple or regular transfusions – Regular transfusions carry the risk of iron toxicity. A consultation is necessary as patients must be aware of such risk and other possible complications. Working together with a doctor, this and other risks can be minimized.
Surgery is to be performed – Bleeding is one of the major risks of any surgical procedure because certain blood vessels may be damaged in the process. During a pre-surgery consultation, this risk is explained to the patient and the possibility of blood transfusion. This allows patients to raise any concerns and to better understand the procedure. A blood transfusion may also be needed post-surgery if internal bleeding occurs.
A blood transfusion consultation can be for both the patient and the donor. One of its main goals, aside from discussing possible risks and complications, is to ensure that both individuals are ideal for transfusion. If the blood is coming from a blood bank, issues such as possible contamination, must also be covered.
How Does the Procedure Work?
Before the patient is scheduled for a blood transfusion consultation, his primary healthcare provider or surgeon will determine first if the procedure is required by running tests and assessing the patient’s condition and overall health. Once confirmed that blood transfusion is required, the patient will be referred to a hospital’s blood department for consultation.
During the consultation, the person-in-charge will interview the patient on:
- Reason for blood transfusion
- How much blood is needed
- Kind of blood to be transfused
Transfused blood these days can be autologous or donated. It is autologous if the blood is obtained from the patient. This is usually elective and performed before surgery. However, this is not an option in emergency cases. Meanwhile, donated blood can come from different sources such as family and other relatives, friends and strangers. The blood may also be obtained from blood banks, which hold different types of blood for future use. Blood drawn from recognized banks and health care facilities go through very strict screening procedures.
Once all the above information is known, the person-in-charge will schedule the patient for blood transfusion. To minimize the risk of complications, certain instructions such as how to prepare for the procedure, including getting enough rest and limiting activities, will also be given to the patient.
Before blood transfusions are carried out, a nurse will obtain readings of vital signs such as blood pressure and heart rate. After the procedure, the in-charge may then refer the patient back to his physician for follow-up.
A typical consultation is usually completed within 20 to 30 minutes unless tests, such as blood typing, are needed.
Possible Risks and Complications
Blood transfusion policies can differ among health care facilities. This can be a challenge for patients who regularly travel as contrasting approaches of policies may be confusing. Some may also not understand the reason for the consultation that they may skip or avoid attending it all together.
Cushing MM, Ness PM. Principles of red blood cell transfusion. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al., eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 112.
Hall BA, Chantigian RC. Blood products, transfusion, and fluid therapy. In: Hall BA, Chantigian RC. Anesthesia: A Comprehensive Review. 5th ed. Philadelphia, PA: Elsevier; 2015:chap 5.