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This application is a service of the Singapore Government.

Health Sciences Authority

Blood Safety

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Overview

The Blood Services Group (BSG) is involved in the advisory, patient management and research levels in Clinical Transfusion Medicine.

Guidelines and updates on the latest developments in transfusion medicine are circulated to hospital physicians and surgeons and blood bank laboratory technologists on a regular basis. In addition, BSG Transfusion Medicine physicians organise regular talks and seminars for the clinicians of the various hospitals, to update them on current transfusion practices and guidelines.

We participate in the training of undergraduate medical and nursing students and also conduct post-graduate training for local and foreign trainees.

Hospital Transfusion Committee meetings are held regularly to discuss the issues, problems and various practical deliberations pertinent to daily transfusion practice. BSG helps guide the blood usage policies, blood transfusion protocols and blood product safety guidelines of the various restructured and private hospitals during these regular meetings between BSG and the Hospital Transfusion Committees (HTCs) of the various hospitals.

Our clinical division is on hand to offer advice to hospital clinicians on the use of blood and blood products. We also advise on management of various transfusion medicine-related clinical problems.

The range of clinical services includes:

  • Direct clinical services to hospital clinicians
  • Clinical liaison with hospital blood banks & HTCs
  • Formulating a set of national guidelines on blood transfusion matters for hospital clinicians
  • Training and teaching
  • Research
  • Haemovigilance
  • Therapeutic apheresis services

Direct Clinical Services to Hospital Clinicians

  • Clinical Support to Hospital Clinicians on matters related to transfusion medicine, including managing patient with coagulopathies, platelet refractoriness, massive blood loss and adverse transfusion reactions, etc
  • Clinical Support to the Laboratory, including advice on blood products utilisation, blood grouping
  • Therapeutic apheresis service

Clinical Liaison with Hospital Blood Banks & Hospital Transfusion Committees

BSG works with all the hospitals in Singapore to optimise the use of our blood resources in the following ways:

  • Regular direct dialogue with the various HTCs and Hospital Blood Bank Laboratory Technologists
  • Help to formulate local hospital guidelines to assist hospital physicians in deciding the appropriate clinical situations where blood component support is deemed necessary, and the use of appropriate products in these circumstances

Formulating a Set of Blood Transfusion Matters for Hospital Clinicians

A set of National Guidelines on Blood Transfusion has been available for all doctors in Singapore since Feb 2011.

The aim is to promote rational and safe use of blood products by equipping hospital clinicians with a reference guide on blood transfusion.

Training and Teaching

BSG is committed to continuing medical education in transfusion medicine at both the undergraduate and post-graduate level.

BSG accepts medical and nursing students for short attachments in every academic year. Polytechnic students from life sciences school and medical technology school are posted here as one of their elective posting during their course of training.

Advanced Haematology Trainees (Registrars) from the various hospitals also join us for short stints to gain experience and training in transfusion medicine.

Expert speakers are invited to talk on topics related to blood banking and transfusion medicine during our regular staff lecture series.

Under the Ministry of Health Human Manpower Development Programme, experts in the field of transfusion medicine are also invited yearly, to keep our doctors in the blood bank and hospitals current with the latest transfusion developments.

As a WHO Collaborating Centre, BSG also helps train doctors, nurses and laboratory technologists from blood banks in our neighboring countries. We host numerous foreign trainees and delegates every year. Our regional training projects include conducting quality management training and providing external proficiency testing in pre-transfusion testing in blood centres across the Western Pacific region.

Research

There is a strong emphasis on research at BSG. Research projects on various aspects of clinical and laboratory blood transfusion matters are undertaken regularly, with an aim for publication in related journals and presentation at blood transfusion medical conferences.

BSG is an active participant in the international transfusion medicine arena, regularly sending speakers and participants to key international conferences including conferences organised by various organisations including WHO, International Society of Cellar Therapy, Japanese Society of Blood Transfusion, International Society of Blood Transfusion, South Asian Association of Transfusion and the American Association of Blood Banks (AABB).

Haemovigilance

Haemovigilance is a set of surveillance procedures covering the whole transfusion chain (from the collection of blood and its components to the follow-up of recipients), intended to collect and assess information on unexpected or undesirable effects resulting from the therapeutic use of labile blood products, and to prevent their occurrence or recurrence.

The Haemovigilance Program in Singapore started in 2002 as a joint initiative between the Blood Services Group (BSG) and public and private hospitals with the following objectives:

  • To gather and analyse reports of all adverse and untoward events occurring during transfusion of blood and components
  • To gather and analyse “near miss” events during the transfusion process
  • To use the information acquired to determine the morbidity of transfusion
  • To provide guidance on corrective measures to prevent the recurrence of some accidents, and to improve transfusion safety
  • To improve public confidence by demonstrating to public, patients and professionals the safety of the existing transfusion system

The data collected about “Near Miss” incidents and the infectious and non-infectious hazards associated with blood transfusion can be used to identify and correct procedural weakness and problems in the system as well as create recommendations to improve blood transfusion safety.

Therapeutic Apheresis Services

Apheresis (Greek: “to take away”) is a technology in which the blood of a donor or patient is passed through an apparatus or machine that separates it out into constituents (red cells, white cells, platelets, plasma, etc), collects the desired component and returns the remainder to the patient or donor.

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Apheresis technology permits the harvest of only the desired
component or components from the blood, returning the
other remaining components to the donor or patient.

Therapeutic Apheresis is the removal of abnormal or pathologic substances from a patient's blood using an automated blood cell separator machine. A replacement fluid such as fresh frozen plasma, human serum albumin or normal saline is often required.

The Blood Services Group (BSG) provides Therapeutic Plasma Exchange services using the latest in apheresis technology to patients in the hospitals.

The decision for doing a Therapeutic Plasma Exchange is made by the physicians from the hospital and the blood bank.

Some of the diseases that may require therapeutic plasma exchange either as a primary or support therapy are listed in Table A.

Table A

  • Myasthenia gravis
  • Acute CNS inflammatory Demyelinating disease
  • Antiglomerular basement membrane antibody disease
  • Demyelinating polyneuropathy with IgG and IgA
  • Cryoglobulinemia
  • Polyneuropathy with IgM
  • Acute and Chronic Demyelinating polyradiculoneuropathy
  • Multiple Myeloma associated with hyperviscosity or renal failure
  • Post Transfusion Purpura
  • Thrombotic Thrombocytopenic Purpura