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Blood transfusion
Blood transfusion is a life-saving intervention provided that
it is carried out correctly and that the transfused blood
is safe for the recipient. Because of inherent risks, transfusion
should be prescribed only for conditions for which there is
no other treatment.
For travellers, the need for a blood transfusion is almost
always due to a medical emergency involving sudden massive
blood loss, such as:
- traffic accident
- gynaecological and obstetric emergencies
- severe gastrointestinal haemorrhage
- emergency surgery.
The safety of blood
and blood products depends on careful selection of donors,
testing all donations for transfusion-transmissible infectious
agents and rigorous control of all procedures involved in
donation, testing and transfusion.
The safety of transfusion depends on appropriate prescription
(only when there is no other remedy), careful checking of
compatibility of the blood or blood product with the recipient’s
blood, and rigorous control of all procedures involved.
In many developing countries, safe
blood products and the expertise to prescribe and carry
out safe transfusion are not available in health care facilities.
The risks associated with unsafe blood transfusion are:
- incompatibility of transfused blood owing to failure
to carry out careful compatibility testing;
- transfusion of infectious agents that cause diseases
such as HIV,
malaria,
hepatitis B, hepatitis
C, syphilis,
Chagas disease (as a result of their presence in the transfused
blood or on transfusion equipment).
Initial management to prevent further blood loss by positioning
the patient correctly helps to maintain adequate blood pressure
and flow of blood to vital organs.
In many cases, transfusion of blood can be avoided by replacing
the blood volume with plasma substitutes (crystalloids or
colloids). In areas where malaria occurs, transfused patients
should receive antimalaria therapy as a routine precaution.
Precautions
- ? Travellers should carry a medical card or other document,
showing their blood group and information about any current
medical problems or treatment.
- ? Unnecessary travel should be avoided by those with pre-existing
conditions that may give rise to a need for blood transfusion.
- ? Travellers should take all possible precautions to avoid
involvement in traffic accidents (see Chapter 4).
- ? Travellers may obtain in advance a contact address at
the travel destination for advice and assistance in case
of medical emergency.
- ? Travellers with medical conditions such as haemophilia,
who may need blood transfusion, must take medical advice
in advance and identify appropriate medical facilities at
the travel destination.
- ? Travellers with a medical condition that necessitates
transfusion of plasmaderived products to replace coagulation
factor or immunoglobulin should obtain medical advice and
make appropriate arrangements in advance.
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