Indication Codes For Transfusion

• Red Cell Transfusion
• Fresh Frozen Plasma
• Cryoprecipitate
• Platelet Concentrates
• Maximun Surgical Blood Ordering Schedule
  • General Surgical
  • Vascular Surgery
  • Orthopaedic Surgery
  • Urological Surgery
  • Obstetric/gynae

Red cell transfusion

R1 Acute blood loss. Maintain volume and Hb>7g/dl in otherwise healthy patients, >9g/dl in elderly patients or those with known cardiovascular disease.

R2 Hb <7g/dl

R3 Hb <9g/dl in elderly or patients with known cardiovascular disease.

R4 to maintain Hb>7g/dl, e.g. critical care patients

R5 Chemotherapy patients, maintain Hb >8g/dl
R6Radiotherapy patients, maintain Hb>10g/dl
R7 Chronic anaemia. Maintain Hb slightly above threshold of symptomatic features (>8g/dl in most patients).

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Fresh frozen plasma

F1 Factor deficiency replacement, only where no single factor product is available.
F2 Reversal of warfarin effect, only in the presence of major bleeding.
F3 DIC, associated with significant bleeding and abnormal clotting tests.
F4 TTP, using plasma exchange. (Consider use of cryo poor plasma)
F5 Massive Tx, to maintain PT and APPT ratios <1.5.

F6 Liver disease, to correct bleeding or prior to surgery where INR >1.5

Cryoprecipitate

C1 DIC, associated with continuing blood loss and Fib <1g/l
C2 Liver disease, to correct bleeding or prior to surgery, where Fib <1g/l
C3 Thrombolytic Rx, with bleeding associated with hypofibrinogenaemia.
C4 Massive Tx, where Fib <1g/l
C5 Hepatic/renal failure, with abnormal bleeding and where DDAVP is not a suitable alternative.

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Platelet concentrates

BONE MARROW FAILURE:
P1 Plt count <10x10^9/l (prevention of spontaneous bleeds)
P2 Plt count <20x10^9/l in patents with risk factors such as sepsis (spontaneous bleeds)
P3 Prior to invasive procedures. Discuss with Haematology medical staff.
SURGERY/MASSIVE Tx
P4 Massive Tx. Maintain >50x10^9/l
P5 Non correctable bleeding associated with possible plt dysfunction. Discuss with haematology medical staff
P6 DIC, in the presence of continuing blood loss and thrombocytopenia
P7 Other. Discuss with Haematology medical staff.

Requests for components other than those listed above will be referred to a member of the clinical haematology staff.

MAXIMUM SURGICAL BLOOD ORDERING SCHEDULE (MSBOS)

The following list specifies the MAXIMUM blood order normally accepted by blood transfusion for the listed procedures.

Where clinical need exists for orders in excess of those listed, a telephone call from a senior member of the clinical team is required. In the absence of such telephone request, the department will only provide blood in accordance with the MSBOS.

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