Reducing blood wastage through introduction of a transfusion team.

Background: In the intense setting of reception and resuscitation of critically bleeding patients, wastage of up to 10% of blood components occur, commonly due to prolonged breaks in the cold chain. Additionally, some transfusions may be avoidable. The aim of this study was to assess the impact of dedicated transfusion teams (staff focused solely on blood handling during resuscitation) on blood component wastage and transfusion volumes.

Methods: This was a retrospective pre- and post-intervention study. We introduced a transfusion team for all episodes of blood transfusion in a level 1 trauma centre. The core elements of the intervention were: (1) dedicated 'blood checkers' without other competing duties during the resuscitation, (2) a 17-minute timer activated on receipt of blood components, (3) telephone for communication with the blood bank, and (4) a pre-determined process of blood component request, usage and return discussed at the initial team huddle.

Results: Patient demographics, indications for transfusion and massive transfusion rates were similar between the pre- and post-intervention periods. During 01 Jan 2019 to 30 Jun 2021 (pre-intervention), 109 (1.7%) of 6619 blood component units dispensed were wasted. Following the intervention, until 30 Jun 2023, 73 (1.1%) of 6575 units were wasted (p = 0.008). In the post intervention period, median patient transfusion volumes were significantly lower at 2 (inter-quartile range; IQR 2-6) compared to 3 (IQR 2-6) units (p = 0.002).

Discussion: Dedicated transfusion teams during emergency use of blood were associated with lower wastage and lower transfusion volumes. Transfusion teams may lead to more precise management of critical bleeding, while enabling cognitive capacity for the team leader to focus on identifying and controlling haemorrhage.