BLOOD TRANSFUSION

DEFINITION:
- A transfusion is the transfer of whole blood or blood components such as blood cells &
plasma from one person to another person.
PURPOSE:
- To replace the blood volume
- To increase the oxygen carrying capacity
- To provide Hemoglobin & WBC in severely ill patient
- To correct the deficiency of plasma protein
- To combat infection in leukopenia
- To replace the blood with haemolytic agents with fresh blood.
To provide antibodies.

INDICATIONS
- Anaemia sudden loss of blood due to haemorrhage, trauma or burn.
- Deficiencies of plasma protein, clotting factor & haemophilic globulin etc.
- Erythroblastosis foetalis, haemolytic, etc.
- Agranulocytosis, leukopenia
COMPONENTS OF BLOOD:
1. Blood plasma
- Water (91.5%)
- Proteins (7%)
- Other solutes (1.5%)
2. Formed element
o Red blood cell
o White blood cell
o Platelets
TYPES OF BLOOD GROUP
ABO blood group

Rh group

-Group A

-Rh - ve

- Group B

-Rh + ve

- Group AB
- Group O

BLOOD PRODUCTS:
- Packed RBC s (1u =250-350ml)
- Frozen RBC s (stored for 3 yrs at 188.6 0 F)
- Platelets (1u=30-60ml of platelet)
- Fresh frozen plasma (1u =200-250 ml)
- Albumin( available in 5% or 25% solution)
- Cryoprecipitates (10-20ml/ bag)
SELECTION OF BLOOD DONOR:
- Donor should be free of diseases of heart , kidneys, lungs, liver etc
- There should be no history of chronic illness
- Not donated blood within the previous 90 days
- They should be physically healthy &
- between 18-65 yrs of age
- Donors vital signs should be normal
- Not have been pregnant within the last 6 months
- Hemoglobin (Hb) should be greater than 12gm/dl
- Donors are disqualified who have H/O recent dental surgery, major surgery , recipient of
blood, immunization & use of narcotics
TRANSFUSION COMPLICATIONS
Acute Transfusion Reaction

Delayed Transfusion Reaction

ACUTE TRANSFUSION REACTION

1. Acute hemolytic reaction -infusion of ABO incompatible blood antibodies in the recipients
plasma attach to antigens on transfused RBC s causing RBC s destruction
2. Febrile non hemolytic -sensitization to donor WBC s, platelets or plasma protein
3. Mild allergic reaction -sensitivity to foreign plasma proteins
4. Anaphylactic & severe allergic reaction
5. Circulatory overload and Sepsis
DELAYED TRANSFUSION REACTION
1. Delayed hemolytic reaction
2. Iron over load
3. Disease transmitted by transfusion like hepatitis B & C, AIDS, cytomegalovirus and graft
Vs host disease
NURSING MANAGEMENT FOR TRANSFUSION REACTION
1. Stop the transfusion
7. Notify the blood bank that a
2. Maintain the IV line with normal
transfusion reaction case has
saline
occurred
3. administer at slow rate
8. Send the blood container & tubing
4. Assess the patient carefully
to the blood bank
5. Monitor the vital signs carefully
9. Obtain appropriate blood sample
6. Inform the physician of the
from patient
assessment findings
10. Collect a urine sample for
hemoglobin determination
11. Document the reaction according to institution policy

PROCEDURE CHECKLIST
BLOOD TRANSFUSION
Equipments
1. Cannula 18G or 19G catheter
2. IV set of 0.9 % normal saline solution
3. Sterile Gloves
4. Blood administration set
5. Blood bag
6. Thermometer
7. BP apparatus
8. Stethoscope
Action
1. Check physician order.
2. Ask if the patient has had transfusion or a transfusion reaction in the
past.
3. Assess patients condition.
4. Prepare equipments.
5. Advise patient to report any chills, itching, rashes, or unusual symptoms.
6. Perform hand hygiene.
7. Put on clean gloves.
8. Hang container of 0.9 % normal saline with blood administration set to
initiate IV infusion and follow administration of blood.
9. Start IV with 18 or 19 gauge catheter if not already present keep IV
open by starting flow of normal saline
10. Obtain blood product from blood bank according to agency policy.
11. Complete identification and checks as required by agency.
a. Identification number
b. Blood group and type
c. Expiration date
d. Patients name
e. Inspect blood for clots
12. Take baseline set of vial signs before beginning transfusion especially
temperature.
13. Start infusion of product as follow:

a. prime inline filter with blood.

b. start administration slowly stay with the patient for the first 5 to 15 minutes of
transfusion.
c. Check vital signs at least every 15 minutes for the first half hour
d. Observe patient for flushing, itching, hives or rash.
e. Use a blood warming device, if indicated, especially with rapid transfusions
through CVP catheter.
14. Maintain the prescribed flow rate as ordered.
15. When transfusion is complete, clamp off blood and begin to infuse 0.9 %
normal saline.
16. Clean and return equipments.
17. Remove gloves.
18. Wash hands.
19. Record administration of blood and patients reactions.
20. Return blood transfusion bag to blood bank according to agency policy.
Students signature:

Instructors Signature:

AA

Date