Febrile, non-hemolytic

Due to reaction to donor WBC

*Most common type of
transfusion reaction use
leukocyte reduction filter

Acute hemolytic i.e. ABO & Rh

(less common) incompatibility
Due to increased antibody level
* most life threatening with as
little as 10 ml of blood

Allergic
Due sensitivity to
plasma protein
Rx with
antihistamine,
epinephrine,
corticosteroids

Circulatory overload
RX- slow infusion,
diuretics PRN, o2
morphine

bronchospasm
Dyspnea
SOB

Severe
bronchospasm
Laryngeal edema
SOB

Dyspnea/orthopnea
Pulmonary edemapink frothy sputum
Crackles

Anxiety
restlessness

restlessness

Sudden anxiety
Restlessness

Bacterial
Platelets are at a greater risk because stored
at room temp.
Transfuse RBC & whole blood within 4 hours
period
RX with fluids & antibiotics before septic
shock occurs

Hematuria hemoglobinuria
Acute renal failure
Nausea/vomiting
Chest pain/tightness

Decreased BP

Increased BP

Decreased BP

Tachycardia
Jugular vein
distention/ edema
(can indicate cardiac
failure)
Ecchymosis
petechiae

Chills
Diaphoresis
Fever
Muscle stiffness

Delayed hemolytic
Anemia
Increased bilirubin
jaundice
fever
Chills
Fever
Torso/Low back pain

Rashes
Hives
Urticaria
Generalized itching
flushing
swelling

chills
Fever

General information related to blood transfusions:

Whole blood = 450 ml and 50ml of anticoagulant not commonly used

! Platelets can store at room temperature for up to 5 days gently agitated while
stored to prevent clumping
Fresh Frozen Plasma Expands Blood volume and provides clotting factors
Not necessary to type and screen no RBCs
Is immediately frozen to preserve the activity of clotting factors lasts for 1
year if frozen
Plasma can be further divided into albumin, immune globulin (concentrated
antibody solution used to treat recurrent bacterial infection i.e. CLL), and
clotting factors VIII (antihemophilic factor) and IX (prothrombin complex
treats hemophilia).
Plasma albumin in a large protein that stay within the vessel. Used to expand
oncotic pressure in hypovolemic shock
Packed RBSs One unit raises HCT by 2-3%
o very concentrated Hct = 70%
o can store refrigerated up to 42 days
O-negative is universal donor blood does not stimulate an antibody reaction - blood of choice in
emergency situation
AB blood is universal recipient blood does not react against any type of blood.
A blood cannot receive B blood. B blood cannot receive A blood.
Autologious blood Client donates own Blood
o Ideally collected 4-6 weeks before surgery
o Cannot be performed within 72 hours of surgery
o Can never be used for general population only to general donor- can save for up to 10 years

 Administration of Blood

Confirm order for transfusion Check patients type and cross match
Verify consent Take V/S to establish a baseline
20 gauge or larger IV Cath & Y- type tubing for blood and normal saline
Use blood tubing with filter to screen out fibrin clots and other particulate matter
Check blood for gas bubbles(may indicate bacterial growth), unusual color and cloudiness
(may indicate hemolysis)
o Never add medication to blood or blood products
o Only infuse with Normal Saline.
o Obtain blood from blood bank after intravenous line is established
o Initiated infusion within 30 minutes after removal from blood bank refrigerator
o 2 person check with another nurse or physician
! Double identifiers
! Check ABO group and Rh type
! Check number and type on donor blood label
o Run infusion slowly for first 15 30minutes about 5ml/min to detect a reaction
! Observe for adverse reaction If reaction, STOP infusion immediately
o Infusion time not greater than 4 hours
o Change tubing after every 2 units transfused to decrease chance of bacterial contamination
o Post Transfusion:
! Obtain V/S compare with baseline
! Dispose equipment as per institution policy
! Document -Monitor response to transfusion labs, patient response (feels better
more energy, stable V/S)
Transfusion of Platelets
o Same as above with the following differences
o Infuse each unit as fast as patient can tolerate to diminish platelet clumping during
administration
o A platelet count may be ordered 1 hour after platelet transfusion
o
o
o
o
o