BLOOD AND

BLOOD
PRODUCTS

Hemapriya M.Sc. Nursing

Nursing officer

CNT II Floor
Blood products

Whole Blood
One unit of donor blood collected in a suitable anticoagulant-preservative
solution and which contain blood cells and plasma

Blood Components
A constituent separated from whole blood, by differential centrifugation of
one donor unit or by apheresis.
Blood Derivatives
A product obtained from multiple donor units of plasma by fractionation.
BLOOD COMPONENTS
– From a unit of
whole blood, the
centrifuged product
settle out into
RBC,WBC &
platelet-rich
plasma(PRP).
– After separating
PRP fr the bag,PRP
again being
centrifuge for a
longer time &
harder spin.
– Plt is heavier than
plasma & will
settled at the
bottom of the bag.
Blood transfusion
– Components of blood introduced to the patient
through IV line
– COMPONENTS
• RBC
• WBC
• Platelets
• Plasma
• Whole blood
• colloids
 Platelets
Random donor platelet (RDP) Single donor platelet(SDP)

– Other than same blood group – Same blood group

– Storage – 7 days – Storage – 5 days
– Time of infusion – 15- 30 min – Time of infusion- 1 1/2 – 2 hours
– Increase 12,000 – Increase 50,000(18-24 hrs)

6RDP = 1 SDP
PLATELETS
SHELF LIFE
QUALITY CONTROL
5-7 days in platelet incubator
STORAGE RDP- 5.5 x 1010 /bag Plasma
& agitator.
t 20-24 degree C - 30 to 50 ml.
24 hrs.- if no storage cabinet
SDP- 300 ML

TRANSFUSION
TRANSFUSION CRITERIA
Started immediately
SDP-Current ABO and Rh (D) Group and Antibody Screen required. RDP -15 to 30 min.
RDP - ABO and Rh (D) Group and Antibody Screen NOT required. SDP – 1 ½ - 2 HOURS.

INDICATION
Severe thrombocytopenia, qualitative platelet defects Effect: Aplastic anemia,
Leukemia, Defective Platelet Function, Congenital Platelet Disorders
PLASMA

– After removing RBC & WBC.

– Used as plasma expander/ clotting factor.
– Contains protein & albumin used in burns.
– Cryoprecipitate is a process to segregate
clotting factor.
FRESH FROZEN PLASMA
STORAGE
SHELF LIFE QUALITY CONTROL
< -18 c use immediately after
thawing. FROZEN: 1 YEAR Prepared within 6 hrs of
40 degree C or colder THAWED: 24 hrs whole blood collection.
If not Factor VIII and Factor V Volume: 150-250 ml
deteriorate

TRANSFUSION CRITERIA TRANSFUSION

Once thawed FFP should be
infused within 30 minutes.
Current ABO and Rh (D) Group and
Within 2 hrs of thrawing.
Antibody Screen required

INDICATION
Clinically significant deficiency of Factors II, V, X, XI, DIC,Plasma exchange,
Immunodeficiencies Massive transfusion of stored blood. Liver disease, Urgent
reversal of warfarin therapy,Correction of known coagulation factor deficiencies for
which specific concentrates are unavailable
CRYOPRECIPITATES/ CLOTTING FACTOR
QUALITY CONTROL

STORAGE SHELF LIFE

(1 unit)Volume - 10-20 ml

FROZEN: 1 year
Factor VIII-C - 80-120 IU
S -18 degree C or Factor VIII R: Ag - high levels
POOLED: max 4 hrs
colder
THAWED: within 6 hrs Factor VIII vWF - high level
P-20-24 c Fibrinogen - 150-200mg / bag
T-37 c Factor XIII - 20-30% of original level

TRANSFUSION CRITERIA
TRANSFUSION
ABO compatibility not Once thawed cryoprecipitate should be
transfused within 30 minutes-6 hrs .
required.
INDICATION
DIC ,Factor XIII deficiency , Uremic Coagulopathy , Fibrin Glue ,
Factor VIII ( haemophilia A , von Willebrand disease ).
WBC

–Blood cancer.
–Chemotherapy
–Neutropenic patient with fever.
GRANULOCYTES
SHELF LIFE

STORAGE Expiration time is 24 QUALITY CONTROL

hours but best to infuse 1 x 10 granulocytes.
20-24 C. ASAP. Volume:200-600ml.

TRANSFUSION CRITERIA
TRANSFUSION
Current ABO and Rh (D) Group and Antibody Screen should be transfused within ½
required. hour of release from BTS.
Infusion time for 1 unit -1 hrs.
HLA matched usually.

INDICATION
Supportive tx for pt with severe neutropenia with
documented sepsis unresponsive to a/biotic tx.
1.Neonatal sepsis.
RED BLOOD CELLS(PRBCs)
SHELF LIFE
QUALITY CONTROL
CPD: 21 DAYS
STORAGE CPDA:1-35 DAYS 200 -300 ml
CPD-AS:42 DAYS Hct must be< 80 %
+2 degree C to +6 degree C
HEPARIN :2DAYS
RBC in AS :Hct < 65%

TRANSFUSION CRITERIA
TRANSFUSION
should be transfused within ½ hour
Current ABO and Rh (D) Group and Antibody Screen of release from BTS.
required
Infusion time for 1 unit -2 to 4 hrs.
1 unit RBCs should raise HCT : 2-3%, Hb 1 g/dl(after 6 hrs)

INDICATION
Restore oxygen carrying capacity symptomatic anemia and surgical blood loss.
CABG :HB ≤6.0 g/dL is indicated.
< 65,CARIO,RESP DISEASE:HB level ≤7.0 g/dL
STABLE PT :7 and 10 g/Dl
acute blood loss more than 1,500 mL or 30% of blood volume.
ALBUMIN
DEFINITION INDICATION PRCAUTION
• Burns • Administration of 20%
• Prepared By Fractionation Of
• Shock (Add Volume albumin may cause
Large Pools Of Plasma Expanders) pulmonary edema
• Replacement Fluid Following • Close monitoring is
• Process Of Fractionation Plasmapharesis. essential.
• Diuretic Resistant Edema In: • Hypersensitvity reactions
Inactivates Viruses.
• Ascites may occur.
• Eg. Hiv/Hbv • Nephrotic Syndrome
UNJUSTIFIED INDICATIONS
• Stored At Room Temperature • Cirrhosis
• No Filter Is Needed When • Chronic renal failure
• Malnutrition
Infusing
• N/S Or Ringer’s Can Be Added
IMMUNOGLOBULINS
DEFINITION
• Concentrated ab
containing component of
plasma (igg)
• Obtained by fractionation of
plasma ( virucidal )
• Specific hyperimmune ig is
prepared from donors with
high titres of a specific
antibody
• Preparations available in
both im and iv forms
INDICATION PRCAUTION
IMI IMMUNOGLOBULINS: ANAPHYLACTIC REACTIONS
1. Anti-D for the prevention of CAN OCCUR IF:
HDN in sensitized Rh. • IMI product is given IVI.
neg. mothers • The patient previously had a
2. Others to prevent / Rx reaction toward a human
tetanus, rabies, hepatitis protein product
A&B • The patient suffers from IgA
IVI IMMUNOGLOBULINS: deficiency
1. Agammaglobulinemia
2. Immmunodeficiency states,
including HIV
3. Idiopathic thrombocytopenic
purpura (ITP)
Whole blood
STORAGE SHELF LIFE
CPD: 21 DAYS QUALITY CONTROL
+2 degree C to +6 CPDA:1-35 DAYS
350 ML +_ 10%(40 ML AC)
degree C 450 ML +_10%(63 ML AC)
TRANSFUSION

should be transfused within ½ hour of release from BTS.

Infusion time for 1 unit -2 to 4 hrs. TRANSFUSION CRITERIA
1unit RBCs should raise HCT -3%, Hb 1 g/dl Current ABO and Rh (D) Group and
Antibody Screen required

INDICATION
Maintain blood volume & O2 carrying capacity in acute, massive blood loss.
Actively bleeding pt>20% of body blood volume.
WHOLE BLOOD
– INDICATION : Surgery/postoperative.
– IF PATIENT IS ALLERGIC TO WHOLE BLOOD
1) Washed
2) Colloids
3) Autologous donor.
- I unit = 350 ml ( 300 ml blood + 50 ml anti coagulant).
- 3 types of anti coagulant.
1. CPD – citric phosphate dextrose ( 21 days) – less
complication.
2. ACD-acid citrate dextrose (35 days) – more complication.
3. Heparin(temp preservative) - neonate transfusion (2- 4 hrs)
75- 100 ml .
 DONOR PROCESSING

New Donor Haemoglobin

Medical Self Exclusion
presents estimation
Questionnaire Questionnaire
at clinic (Copper Sulphate)

Tested for Blood Pressure

HIV Antibody (102) Pulse
Donor Unit HIV P24 Antigen Weight
accepted for Hepatitis B Surface Antigen
patient use Hepatitis C Antibody
Syphilis
Blood Groups UNIT of BLOOD
Irregular Antibodies DONATED
DONOR CRITERIA
– Age 18 -65 years.
– Healthy
– Female > 45 kg
– Male>50 kg.
– Hb > 12gm/dl.
RECIPIENT
Adult Hb < 8 gm/dl .
Infant < 13 gm/dl.
DISEASE CHECK
– HEPATITIS C ( most transferable through BT)
– HEPATITIS B
– HIV
– MALARIA – ( more than 5 year)
– VDRL- accept as donor because bacteria
destroy with in 72 hours and below 6 degree
– JAUNDICE – life long do not donate.
Collection / storage and
transfusion
– Storage in hospital blood band – 1- 6 degree c
– Camp 8 degree.
– All blood products to be transported to hospital
blood bank with in ½ a hours after receiving.
– To prevent haemolysis.
PROCEDURE
1. Doctors order.
2. Informed consent
3. Intravenous line ( donor- 16G , recipient – 18 G )
4. Blood to be checked for cross match by 2 registered nurse –
for date of expiry and blood group.
5. Vitals signs – to be checked before and during if rise in temp
99 F – first nursing action NOTIFY DOCTOR.
6. Every oral medicine to be given before 30 min and IV can be
given just before transfusion.
7. First 15 min – critical time.
8. Site adult – antecubital vein, infants – umbilical vein , if
absent go for femoral vein. Anterior scalpel vein is only for IV
fluids not for blood transfusion.
 COMPLICATION OF TRANSFUSSION
COMPLICATION CAUSE SIGNS/ SYMPTOM NURSING ACTION
CARDIAC OVERLOAD 250 ml in ½ hour Tachycardia Slow the infusion
Distended jugular vein Fowler position
Crackle sound Notify doctor
Cough O2 administration/diuretics
HAEMOLYTIC REACTION No cross match Hypotension Stop infusion
Not same blood group Tachycardia Notify doctor
rashes Anti allergic drugs- dexamethasone
/hydrocortisone
HYPOCALCEMIA Normal 8.6- 10 mg/dl Muscle spasm Slow infusion
Citrate toxicity Tetany Notify doctor
Ca gluconate ( 1 ml in 100 ml NS- given
after each 100 ml of infusion).
HYPERKALEMIA 3.5- 5.1 meq/dl Abdominal cramps 5 % dextrose + insulin
If old blood more than Numbness Vexalate ( enema)
21days. Diarrhoea
hemolysis Ecg- ST ele /QRS widen/ tall T
wave
IRON OVERLOAD Recurrent episodes of Nausea Deferoxamine
blood transfusion Vomiting urine red colour