The decision to transfuse a patient must always be carefully considered and the benefits should always outweigh the risks. This section signposts many tools that are available to indicate when a transfusion is appropriate, how to authorise and administer a transfusion safely as well as the consideration of suitable alternatives to transfusion. Patient safety is paramount throughout the entire transfusion pathway therefore this section incorporates patient consent, sampling requirements, bedside checks, the use of information technology to enhance safety and security and how to avoid errors.