Use of Expired Blood Bag without Verification

[2] Transfusion Procedure Phase – 10 Possible Error Cases 

1	Omission of pre-transfusion vital signs check
2	Patient and blood verification performed by only one healthcare provider
3	Use of blood transfusion set filter for more than 6 hours
4	Blood transfusion started more than 30 minutes after blood issue
5	Simultaneous administration of 5% dextrose during transfusion → coagulation occurred
6	Transfusion initiated without explaining its purpose and procedure to the patient
7	Storage temperature deviation during transport from blood bank to ward
8	Connection of a different blood product than the physician's order
9	Red blood cells transfused using an infusion pump → red cell damage occurred
10	Use of expired blood bag or one with improper storage conditions

Transfusion Procedure Phase – 10 Possible Error Cases 

 

 

 

 

 

 

 

 Simulation Scenario 10. Use of Expired Blood Bag without Verification

Patient: 74-year-old female, admitted with severe anemia following a GI bleed. Hemoglobin: (6.5) g/dL. Doctor ordered 1 unit of Packed RBC for transfusion.

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Nurse (New)
I brought the blood from the blood bank. I've set up the transfusion line. Should I begin the transfusion now?

 

Nurse (Senior)
Did you check the expiration date and storage status of the blood unit?

 

Nurse (New)
(Flustered) I… checked the patient information and the blood type, but I didn’t check the expiration date... Should I stop?

 

Nurse (Senior)
(Immediately walks over, examines blood unit)
This PRBC expired two days ago. Look — the label clearly shows the date. And this bag feels warmer than 6 degrees Celsius.

 

Nurse (New)
Oh no... I thought the blood bank always checks that before issuing blood.

 

Nurse (Senior)
They do, but final responsibility lies with us. Every nurse must verify expiration date, blood temperature (1–6 °C), and visual appearance before starting transfusion.

 

Nurse (Senior)
(Returns blood unit to cooler)
Let’s report this immediately and get a replacement. We cannot transfuse expired or improperly stored blood — risk of hemolysis, sepsis, and transfusion reaction is too high.

 

 

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Emergency Response Protocol

1. Transfusion not started — no immediate patient harm occurred
2. Return expired blood to blood bank with incident note
3. Document incident and report to charge nurse & physician
4. Obtain new blood after full verification (expiry, storage, patient match)
5. Reinforce 3-point check with junior nurses (Patient – Label – Expiration)

 

 

 

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Doctor Kim
Thanks for reporting before starting the transfusion. Expired blood can lead to acute hemolytic reaction, febrile non-hemolytic reactions, or even septic shock.

 

Nurse (Senior)
We’re re-educating on the 5-rights of transfusion and will log this for quality improvement.

 

Patient (Mrs. Han)
So I didn’t get the blood yet? Is something wrong?

 

Nurse (New)
We noticed the blood wasn’t suitable before starting — thank you for your patience. We're making sure everything is 100% safe before giving you anything.

 

Patient (Mrs. Han)
I appreciate you being cautious. Please take your time.

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✅ Key Learning Summary

Item Key Point

Situation	Blood unit expired and not stored at proper temperature, nearly used without verification
Nursing Action	1) Detected error before transfusion

1. Blood returned to bank, new request initiated
2. Incident documented, physician notified
3. Patient reassured and monitored | | Documentation | Record discovery of expired blood, who returned it, time, physician contact, replacement process | | Clinical Education Points | ✅ Always verify: expiration date, storage condition (1–6 °C), visual integrity before transfusion
   ✅ Use a 3-point check: Patient ID – Blood Label – Expiration Date
   ✅ Even small oversights can lead to severe transfusion reactions |

 

 

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👉 Catheter Management : CVC, PICC, and Implanted Port (Chemoport)

Catheter Management Scenarios: Central Venous Catheter (CVC), Peripherally Inserted Central Catheter (PICC), and Implanted Port

 

👉 Oxygen Therapy(Nasal prong, Mask, Nebulizer)

Applying a Nasal Prong for Oxygen Therapy

 

👉  Transfusion-10 possible Error 

Scenario 1. Crossmatch Completed, but Blood Bank Sent Mismatched Blood → Nurse Identifies Error During Dual Verification and H

Use of Expired Blood Bag without Verification