BLOOD TRANSFUSION

1. Identify source bleed

2. Blood volume replacement
Monitor
pulse, BP,
RR

DONOR
DONORs
BLOOD
4C on storage
properly of
blood changes
Centrifuged

Indication

Donor blood

Complication of
blood
transfusion

Pulse increase (shock)

BP hypotension
RR increase
Venous access IV
0.9N
Normal saline
Condition
18 yr- 45 yr
450 ml maximum quantity In a year 3 times so 450 ml x 3
Haemoglobin: 11 G
450 ml blood x adenine citrate Dextrose (ACD)- anticoagulant
Stored at 4 C last for 3 weeks
After 3 weeks discard the blood
1. RBC biconcave (N) integrity detererioted lysis
2. WBC number decreases
3. Platelet- number decreases
Oxygen carrying capacity decreases
Metabolism decreases anaerobic lactic acid increases acidosis increases
Centrifuged
i.
RBC packed - 6 weeks
ii.
Plasma high speed centrifuged
o
Fresh frozen plasma
o
Platelets
o
Coagulation factor
1. Acute loss of blood for volume replacement (accident)
2. Anemic patiet undergoing surgical procedure
Eg carcinoma of stomach
3. Haemoglobin less than < 6g increase Oxygen carrying capacity
Eg. Fibroid loss lot of blood remove uterus Bring Hb 11G
Test for
i.
Hepatitis B
ii.
Hepatitis C
iii.
Syphilis
iv.
HIV
v.
Malaria
Group Rh factor
A, B, O, AB (rare universal recipient)
O commones universal donor
Cross match not matched acute renal shut down
1. Allergic reaction : high fever, chills rigors (allergen in blood system) hyperemia
What should be done?
Stop blood transfusion, Anti histaminic ,Chlorperamin
2. ABO mismatch blood
Shivering, rigor, Groin severe pain, Hypotension
Anuria
In anuria - RBC broken down, tubules of kidney get blocked anuria
What should be done?Stop transfusion check BP
IV diuretic Furesemide 40mg loop diuretic reduce the blockade increase urine
output
Jaundice seen after few days, RBC broken down excessively AVOID by checking blood
right before giving blood
3. Congestive cardiac failure
Large volume of blood transfuse heart fail to pump Eg: in accident bleeding in
internal
4.
5.
6.

Autologous
blood
transfusion

organ massive blood transfused heart not able to function

ACD- citrate increase citrate toxicity
Diseases transmitted Hep A, B, C, syphilis, malaria
Administered old blood induced acidosis hyperkalemia

1. Surgery- 4 weeks prior donate blood 450ml, 11G stored

15 days prior- body replaced blood donated in 15 days
Day before surgery 11G
2. Very hard to get a donor

3.
4.

Rare group AB group

Disease not transmitted