From the Guidelines
Informed consent for blood transfusion should be obtained by discussing the procedure, benefits, risks, and alternatives with patients before administering blood products, as recommended by the most recent guidelines 1. The process of informed consent for blood transfusion involves several key elements, including:
- Explaining why the transfusion is necessary, such as severe anemia, blood loss, or clotting disorders
- Discussing the specific blood components being administered, such as red blood cells, platelets, plasma, or other products
- Informing patients about potential risks, including allergic reactions, fever, transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), iron overload with multiple transfusions, and the extremely rare risks of infection or incompatibility reactions
- Covering alternatives to transfusion when applicable, such as erythropoietin therapy, iron supplementation, or autologous blood donation
- Documenting the patient's understanding and agreement in the medical record, as emphasized by the importance of respecting patient autonomy and ensuring informed decision-making 1. In emergency situations where obtaining consent is impossible and delay would threaten life, transfusions may proceed under implied consent, with documentation of the circumstances, as noted in guidelines for qualified consent 1. The discussion of informed consent should be tailored to the individual patient's needs and circumstances, taking into account their values, preferences, and any religious or personal beliefs that may impact their decision-making, such as those of Jehovah's Witnesses 1. By prioritizing informed consent and respecting patient autonomy, healthcare providers can ensure that patients receive the best possible care and make informed decisions about their treatment, ultimately improving morbidity, mortality, and quality of life outcomes.
From the Research
Informed Consent for Blood Transfusion
- Informed consent for blood transfusion is a necessity due to the known risks associated with this service 2.
- Patients needing blood transfusion require full information on the benefits and risks in order to make informed consent 3.
- The benefits of, risks of, and alternatives to blood transfusions are not consistently understood by patients 4.
Process of Gaining Informed Consent
- All transfusion services should institute written informed consent that clearly defines the patient's options, including the use of homologous blood, autologous blood, and directed donations 2.
- Patients should be informed about and understand the purpose, benefits, and potential risks of transfusion, and have an opportunity to discuss their treatment options 5.
- A standardized video regarding the risk and benefits of blood transfusions can be used as an educational tool to improve patient understanding 4.
Importance of Patient Understanding
- The information recollected from informed consent discussions can be variable and incomplete 4.
- Patients may experience concerns or worry about having a blood transfusion, despite being comfortable with the decision 4.
- Ensuring patient understanding and comfort with the decision to undergo blood transfusion is crucial for informed consent 4, 5.