BLOOD TRANSFUSION

Introduction of blood or its component directly into the circulatory system

INDICATIONS

Blood loss

Correct Physiologic disorders

Surgery

TYPES OF BLOOD

Type A Has A antigen and has anti-B antibodies

Type B Has type B antigen and has anti-A antibodies

Type AB has both A and B antigen and has no A or B antibodies,

universal recipient

Type O Has no A or B antigen, and has both A and B antibody,

universal donor

COMPONENTS OF BLOOD

NURSING CONSIDERATIONS PRIOR TO BT

Check doctor’s order Cross matching, blood typing

Obtain consent

Obtain history of allergy and fluid status

Prepare and provide checklist

Vital signs, pre-BT, intra BT, post-BT baseline then Q15 x 4; Q30 x 2; then q h

EQUIPMENTS

Blood product

G18 needle, sterile

0.9 NaCl (Plain NSS)

Blood transfusion test with filter

Venipuncture set

Gloves, tape, alcohol swab

PROCEDURE Get pre-transfusion vital signs

Determine previous blood transfusion reactions

After label is checked by the physician, With another nurse, verify: client’s identity Blood unit labels and expiration Blood group and Rh compatibility

Set-up the infusion set Close all the clamp on the Y set, the main flow rate

clamp and both Y-line clamp Spike in twisting motion Hang on the container on the IV pole about 1meter or

3 feet

Start the saline solution, attach the blood tubing primed with NSS to the intravenous catheter

Prime drip normal saline and flush IV line with normal saline to prevent blood from mixing dextrose solution

Invert the blood bag gently several times to mix cells with the plasma, pull the tab and spike the Y set

Infuse slowly for 1st 15 minutes at 10gtts/min, severe blood transfusion reactions occurs within 15-20 minutes of transfusion or within the transfusion of 100ml of blood

Stay with the client within 15 minutes, monitoring vital signs every 5 minutes, noting for ractions. Altered vital signs is the early sign of blood transfusion reaction.

After 15 minutes without noticeable reaction, adjust to consume blood products within ordered duration

If any reaction, STOP THE INFUSION OF BLOOD, maintain infusion of NSS and notify physician

Obtain blood (patient’s blood and the transfusing blood) and urine and send to laboratory per doctor’s order

After transfusion, open normal saline and infuse ubtil tubing is clear

Blood should be transfused within 4 hours from the laboratory, as it is “old blood” rising hyperkalemia

Document relevant data Reactions Vital signs Blood information #of blood to transfused Drip rate Time started and finished

TRANSFUSION REACTIONS Febrile reactions:

Fever Chills Headache Body malaise

Allergic reactions Flushing Urticaria Wheezing Rashes

Hemolytic reactions Facial flushing Chills Low back pain Hypotension Hematuria Anaphylactic shock