Blood Component Therapy To reduce the use of blood products, antifibrinolytic agents and other products may be used

d in some situations. Platelet concentrates, derived from fresh whole blood can increase the platelet level effectively. Centrifuging 500 mL of whole blood derives 1 unit of platelets, a yellow liquid that is usually 30-50 mL in volume. Platelet concentrates from multiple units of blood can be pooled together for a single administration. The degree of increase from a pooled platelet product varies and is usually measured by performing a platelet count within 1 hour following the transfusion. Platelet transfusions can also be prepared by pheresing/removing the platelets from a single donor (blood is removed from the donor, the platelets are removed, and the rest of the blood is reinfused into the donor). This procedure results in 200-400 mL of platelets and plasma. Once acquired from a donor, platelets can be stored at room temperature for 1-5 days. Gentle agitation of the bad is useful to prevent the platelets from adhering to the plastic. Administration Procedure --usually with at least a 19-gauge needle (larger needles [18 or 16] may be preferred if rapid infusions are given). (Smaller needles can be used for platelets, albumin, and clotting factor replacement). Verify venous access patency before requesting the blood component Most blood product administration tubing is of a Y Type with a microaggregate filter (filters our particulate) with one arm of the Y for isotonic saline solution and the other arm of the Y for the blood product. Once obtained, positive identification of the donor and recipient must be made (dual checking system) Make sure patient understands the procedure and the s/sx to report and that they have agreed with the plan. Take vital signs prior to administration o If abnormal (ex: elevated temp) clarify with the physician when to administor Blood should be administered as soon as its brought to the patient. If its not used within 30 mins, it should be returned to the blood bank. During the first 15 mins or 50 mL of blood infustion, you should remain with the patient. If there are untoward reactions, they are most likely to occur at this time. The rate of infusion at this time is no more than 2 mL/min. After the first 15 mins, vitals are re-taken and the rate of infusion is goverened by the clinical condition and the product being infused. Observe the patient periodically throughout (ie: every 30 mins) and up to 1 hour after the transfusion

Most patients not in danger of fluid overload can tolerate the infusion of 1 unit of PRBCs over 2 hours. The transfusion whould not take more than 4 hours to administer.

Acute Blood Transfusion Reactions 1) Stop the transfusion 2) Maintain a patent IV line with saline solution 3) Notify the blood bank and HCP immediately 4) Recheck identifying tags and numbers 5) Monitor vitals and urine output 6) Treat symptoms per physician order 7) Save the blood bag and tubing and send them to the blood bank for examination 8) Complete transfusion reaction reports 9) Collect required blood/urine speciments at intervals to evaluate for hemolysis 10)Document on transfusion reaction form and patient chart