Transfusion medicine handbook

3. Guide to Good Transfusion Practice

3.13 Rate of Transfusion and Precautions

The appropriate rate of transfusion may vary significantly according to the clinical circumstances.

• Patients who are actively bleeding and/or are in hypovolaemic shock will require blood components to be transfused as rapidly as possible.
• Patients with cardiac failure are at risk of circulatory overload and it will be necessary to transfuse slowly and cautiously with frequent monitoring. Concomitant use of diuretics should also be considered.
• Patients, who are assessed as stable, well adults, in the absence of hypovolaemia or risk factors, can tolerate one unit of red cells over 90 minutes.
• For fractionated products, the package insert provides guidance on specific protocols regarding the administration of the product.

Advice must be sought from the doctor responsible for the patient if there is any doubt about the way or how rapidly a blood component or fractionated product should be transfused.