BLOOD TRANSFUSION

BLOOD TRANSFUSION EQUIPMENT

• The infusion of whole blood or a blood component such as • For this procedure, the following are needed:
plasma, RBC, or platelet concentrate into a patient’s 1. Blood Product
venous circulation. 2. Blood Administration Set
• The process of transferring the blood of the person into the o Red color usually
vein of another. 3. 0.9% Normal Saline
• Blood usually runs for 4 hours. 4. IV Pole
• Always remember to check the patient after 15 minutes. 5. IV Catheter (G20, 19, 18)
➢ Because blood transfusion reaction usually occurs o G20 is pink while G18 is green
within 30 minutes after o These are used because they have a
➢ Most important V/S: Temperature bigger lumen
6. Disposable Gloves
COMMONLY GIVEN BLOOD PRODUCTS 7. Tape (Micropore)
• These are usually the following: o To anchor blood set
1. Packed RBC (PRBC) 8. Cross Matching Card – Yellow Card
2. Fresh Frozen Plasma (FFP) 9. BP Apparatus
3. Whole Blood 10. Stethoscope
4. Platelet Concert 11. Thermometer
12. Kidney Basin
13. Flow Sheet
PACKED RBC
• Increases hemoglobin
• Usually used in cases like:
ASSESSMENT
➢ If there is decreased hemoglobin • Obtain baseline assessment of patient including VS,
➢ If there is blood loss condition of the skin, heart & lung sounds, & urinary output
➢ In post-op • Review most recent laboratory values
• Ask about any previous history of transfusion including the
FRESH FROZEN PLASMA number he or she has had, & any reactions experienced
during a transfusion
• Source of all clotting factors
• Inspect IV insertion site and check the type of solution being
• Usually used in cases like:
given
➢ Dengue
➢ If there’s bleeding
• Transfused in succession WATCH OUT FOR REACTIONS
• The most common signs and symptoms include:
➢ Fever Chills
WHOLE BLOOD
➢ Urticaria (hives)
• Contains all blood components
➢ Itching
• Whole blood consists of red blood cells, white blood cells,
• Some symptoms resolve with little or no treatment.
and platelets suspended in a protective yellow liquid known
• However, respiratory distress, high fever, hypotension (low
as plasma.
blood pressure), and red urine (hemoglobinuria) can
• Usually used in cases like:
indicate a more serious reaction.
➢ Emergencies and trauma
o Since all blood components are needed

PLATELET CONCENTRATE
• Typically used to prevent bleeding in asymptomatic severe
thrombocytopenia
• Usually used in cases like:
➢ Bleeding patient with platelet dysfunction due to
thrombocytopenia
o Thrombocytopenia is a condition that
occurs when the platelet count in your
blood is too low
➢ Invasive surgery

BLOOD BAG
• Check for the following:
➢ Collection Date
➢ Unit Number
➢ Expiry Date
➢ Blood Type
➢ Type of Blood
➢ How many ml
o Important to check for intake and output
➢ Barcode
➢ Donor (if available)
➢ Name of the Patient

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 PROCEDURE
STEPS
1) Determine if the patient
knows the reason for
transfusion. Ask if the
patient has had transfusion
reaction in the past
2) Explain the procedure.
Check signed consent.
Advise to report chills,
itching, rash, or unusual
symptoms.
3) Perform hand hygiene. Put
on clean gloves.
4) Hand container of 0.9%
saline with blood
administration set to
initiate IV infusion & follow
administration of blood.
5) Start with G18 or 19
catheter. If not already
present, keep IV open by
starting flow of normal
saline.
6) Obtain blood product from
blood bank according to
agency policy.
7) Complete identification.
Check the following:
➢ Identification
Number
➢ Blood Group and
Type
➢ Expiration Date
➢ Patient’s Name
➢ Inspect blood for
clots
8) Take baseline V/S before
transfusion.
9) Start infusion of blood
product.
A. Prime in line filter with
blood.
B. Start administration
slowly 25 – 50 ml for
the first 15 mins. Stay
with the patient during
the first 5 – 15 mins.
RATIONALE
• Directs teaching
before beginning
transfusion.
• Prevents spread of
microorganisms
• Gloves protects
accidental exposure
to blood
• Dextrose may lead
to clumping of RBC 10) Maintain prescribed flow
and hemolysis
• Filter in
administration set
removes particulate
material formed
during storage of
blood
• Large bore needle
or catheter is
necessary for blood
transfusion.
• The lumen must be
large enough not to
cause damage to
RBC.
• IV should be started
prior to obtaining 11) When transfusion is
blood in case
procedure takes
longer than 30 min
• 12) Record administration of
Blood must be
stored in refrigerated
unit at carefully
controlled
temperature 14
Degrees Celsius.
• Most agencies
require 2 RNs to
verify information:
unit number’s
match, ABO group,
RH type are the
same, expiration
date (after 35 days,
RBC begin to
deteriorate.)
• Blood is never
administered to a
patient without id
band.
• If clots are present,
blood must be
returned to the blood
bank.
• Any changes of V/S
during transfusion
may indicate
reaction.
• Priming is necessary
for blood to flow
properly.
• Transfusion reaction
typically occur
during this period • The patient receives the blood transfusion without any
(15 to 30 mins)
• Slow rate will • The patient exhibits signs and symptoms of fluid balance,
minimize the volume
of the RBC infused.
• If there had been no
C. Check V/S every 15 adverse effects
minutes of the first 30 during this time,
minutes after infusion rate is
transfusion. Follow the increased.
recommendation of the • If complications
institution for V/S occur, they can be
monitoring during observed, and
transfusion. transfusion can be
stopped immediately
• These symptoms
D. Observe patient for
may be early
flushing, dyspnea,
indication of
itching, or rash.
transfusion reaction.
E. Use a blood warming
• Rapid administration
device if indicated,
of cold blood can
especially with rapid
result in cardiac
transfusion through a
arrhythmias.
CVP catheter.
rate as ordered or as
appropriate by the patient’s
overall condition, keeping
in mind the outer limits for
safe administration.
• Rate must be
carefully controlled.
Assess frequently for
• Reaction must be
transfusion reaction.
frequently
monitored.
Stop transfusion and allow
saline to flow if you suspect
a reaction.
Notify physician and the
blood bank.
• Saline prevents
hemolysis of RBC
complete, infuse 0.9% and clears
Saline. remainder of blood
in IV line.
• This provides
blood and patient’s reaction
accurate
as ordered by the agency.
documentation of
Return blood transfusion
patient’s response to
bag according to agency
blood transfusion.
policy.
BLOOD WARMING DEVICE
EVALUATION
evidence of a transfusion reaction or complication
improved cardiac output, enhanced peripheral tissue
perfusion.
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