Blood Transfusion

What is Blood Transfusion?

Introduction of whole or components of the blood to a patient through an intravenous (IV) needle or catheter placed in a patients vein.
RBC, WBC, Platelets, Plasma, whole blood, etc

Can be :
Autologous Homologous synthetic

Blood Groups
Blood Type Antigen
(agglutinig en)

Antibody
(agglutin)

Can donate blood to

Can receive blood from

A B

A B

Anti-B Anti-A None

A, AB B, AB AB

A, O B,O A,B,AB, O

AB A&B (recipient ) O none (donor)

Anti-A & A,B,AB, O anti-B O

Purposes of BT
To replace blood loss(deficit) with whole blood or blood components. Lose large amount of platelets d/t infection Lose of large amounts of blood in:
Accident Surgery

Increase an inadequate number of blood cells (O2, coagulation factors, other blood components). BM does not produce enough blood cells

Correction of anemia caused by chronic conditions. Treatment of immune suppression. Treatment of thrombocytopenia. Replacement of missing clotting factors. Correction of coagulation deficiencies. Treatment of hemophilia or other congenital clotting deficiencies. Treatment of chronic hypoproteinemia. Suppression of active antibody response in Rh negative patients exposed to Rh positive blood.

Equipments in Administering a BT
Blood administration set with filter Intravenous solution of normal saline Blood unit as prescribed by health care practitioner 18 or 19-gauge needle or 18- or 19-gauge catheter; if blood is to be administered rapidly, 14-gauge needle Venipuncture supplies, if client does not have an IV in place Alcohol swabs and tape sterile gloves

Initial Assessment
Verify CONSENT Ensure patency of the existing IV site. Establish baseline data for vital signs, especially temperature, and assess skin for eruptions or rashes. Check clients blood type against the label on the whole blood or blood component prior to administration, to ensure compatibility.

Administering a Blood Transfusion

Verify doctors order If a venipuncture is necessary (Do IV insertion first). Explain procedure to the client Check for the consent. Obtain initial VS. obtain the blood product from the blood bank within 30 minutes before initiation. Verify and record the blood product and identify the client with ANOTHER NURSE. Instruct client to empty bladder first. Wash hands, put on gloves. Open BT kit and move the roller clamps to off position.

For Y-tubing set: Spike NSS bag and open roller the roller clamp on the Y-tubing connected to the bag and the roller clamp on the unused inlet tube until tubing from the NSS bag is filled. Squeeze side of the drip chamber and allow filter to partially fill. Open roller clamp and allow tubing to fill with NSS to the hub. Close the clamp Invert bag once or twice. Spkie blood bag, open clamps on the inlet tube to allow blood to cover the filter completely. Close lover clamp.

For single-tubing set Spike blood unit Squeeze drip chamber and allow the filter to fill with blood. Open roller clamp and allow tubing to fill with blood to the hub. Prime another IV tubing with NSS and piggyback it to the blood administration set with a needle and secure all connections with tape.

 Attach tubing to venous catheter using sterile precautions and open the lower clamp Infuse the blood at a desired rate. Remain with client for first 15-30 mins, monitoring VS every 5 minutes for 15 minutes, then every 15 mins for 1 hour, then hourly until 1 hour after the infusion is completed. After the blood has infused, allow the tubing to clear with NSS. Dispose the bag, tubing, gloves. Was hands Obtain postinfusion vital signs. Document the procedure.

Blood Transfusion Reactions (H-A-P-C-A-T-C-H)

Hemolytic reaction Allergic reaction Pyrogenic Circulatory overload Air embolism Thrombocytopenia Citrate intoxication Hyperkalemia

What to do?
STOP the infusion Flush tube with NSS to maintain KVO Notify the physician Send bag to Blood bank

Nursing Alert!!!
Blood Transfusion Incompatibility
Use only normal saline with a blood product. Blood transfusions are incompatible with dextrose and with Ringers solution. Together, they cause hemolysis, clumping of RBCs.

Transfusion Reaction
The severity of a transfusion reaction is relative to its onset. Severe reactions may occur shortly after the blood starts to infuse. At the first sign of a reaction, stop the blood infusion immediately.