Professional Documents
Culture Documents
Blood transfusion is a lot like marriage. It should not be entered upon lightly, unadvisedly or more often than is absolutely necessary - Beal
3 parts
Although blood transfusions are life-saving procedure, they are have risk also. The most serious risks are transfusion reactions and infections.
WHAT IS BLOOD TRANSFUSION? A blood transfusion is the infusion of whole blood or a blood component such as plasma, red blood cells, or platelets into the patients venous circulation.
PURPOSE OF BTT
* REPLACEMENT * THERAPUTIC 1.To restore intravascular volume with whole blood or albumin. 2. To restore the oxygen capacity of blood by replacing red blood cells. 3. to replace clotting factor and correction of anemia
WHAT IS CROSS MATCHING ? Cross matching is the process of determining compatibility between blood specimens
WHAT IS BLOOD GROUP ? Blood group is an inherited trait, that determines the type of antigens and antibodies present in the blood
BLOOD TYPES A - B - AB - O
Negative
RH
Positive
DONOR
RECIPENT
Blood product transfusions sometimes cause transfusion reactions. There are is any unfavorable transfusion-related event occurring in a patient during or after transfusion of blood components .
what is blood transfusion reaction ? It is abnormal signs and symptoms that will occur during or after transfusion and effects the patients health
Acute Reaction
Causes Sensitivity to plasma protein or donor antibody, which reacts with recipient antigen
Clinical Manifestations Flushing itching ,rash urticaria, hives asthmatic wheezing laryngeal edema anaphylaxis
Management STOP TRANSFUSION IMMEDIATELY KEEP VEIN OPEN WITH NS Notify doctor , infection control, blood bank
Allergic
Prevention
ASSESSMENT (assess the history) before transfusion ask the patient about past reaction. If patient has history of reaction, alert health care provider , emergency drugs should be ready.
Acute Reaction
Clinical
Manifestations
Management STOP TRANSFUSION IMMEDIATELY KEEP VEIN OPEN with NS Notify doctor , infection control, blood bank give antipyretics as directed. check temperature every 1/2hrs.or as indicated send blood samples and blood bags to blood bank. Collect urine samples for testing.
Prevention
ASSESSMENT
Give antipyretic before transfusion as directed Leukocyte LESS blood products may be recommended for future transfusion
Acute Reaction
Causes
Clinical
Manifestations
Management STOP TRANSFUSION IMMEDIATEL KEEP VEIN OPEN with NS Notify doctor , infection control, blood bank give antipyretics as directed. check temperature every 1/2hrs.or as indicated obtain cultures of patients blood return blood bags & blood set to blood bank. treat septicemia as directed ( IV fluids. Antibiotics...
Septic reactions
Prevention
don't keep the blood outside for Longer time because warm temperatures promote bacterial growth. inspect blood for gas bubbles, clotting or abnormal colour.
Acute Reaction
Causes
Clinical
Manifestations
Management
Circulatory overload
If Fluid administrated is greater than the circulatory system accommodation. Increased blood in pulmonary vessels and decreased lung compliance.
raise in venous pressure distended neck veins. Dyspnea Cough Crackles at base of lunges
STOP TRANSFUSION IMMEDIATELY. KEEP VEIN OPEN with NS Notify doctor , infection control, blood bank place patient upright with feet in dependent position. administer prescribed diuretic and oxygen
Prevention
Preferably concentrated blood products should be given. central venous pressure should be monitored for heart disease patient.
Ab (in
responses
-Complement Activation
-Coagulation Activation - Cytokines Effects
Acute hemolytic transfusion reaction
Acute Reaction
Clinical Mainifestations
chills, fever lower back pain feeling of head fullness, flushing oppressive feeling Tachycardia,tachypnea hypotension,vascular collapes hemoglobinurea,hemog lobinemia bleeding acute renal failure
Hemolytic reaction
Incompatible PLASMA
OR
Incompatible RBCs
PREVENTION STOP TRANSFUSION IMMEDIATELY Verify patient KEEP VEIN OPEN with 0.9% identification from saline. sample collection to Notify doctor , infection control, product infusion. blood bank Begin infusion slowly treat shock if present and observe closely draw testing samples, collect urine samples. for 30 min. maintain blood pressure with IV consequences are in colloid solutions. proportion to the administer prescribed diuretic, amount of to maintain blood flow, glomerular incompatible blood filtration, and renal blood flow. transfused monitor hourly urine output.
MANAGEMENT
DELAYED REACTION
Causes
Clinical
Management
Mainifestations
The destruction of transfused flood cells by antibody not detect fever Mild jaundice Decreased hematocrit generaly no acute treatment is required, but hemolysis may be enough to cause shock and renal falure
DELAYED REACTION
Causes
Clinical
Management
Mainifestations
Deposition of iron in the heart, endocrine organs,liver,spleen,ski n and other major organs as a result of multiple, long tearm transfusion . Diabetes Decreased thyroid function Heart failure and other symptoms related to major organ failure Treat symptomatically deferoximine which removes accumulated iron through the kidneys. I.V-I.M-S.C
Iron overload
DELAYED REACTION
CLINICAL CAUSES
MAINIFESTATIONS
Elevated liver enzymes Anorexia, malaise Nausea and vomiting Fever Dark urin Jaundice
MANAGEMENT
Hepatitis B
Hepatitis C
Elevated liver enzymes Chronic liver disease and cirrhosis may develop Night sweats Unexplained weight loos Diarrhea Etc
AIDS
As instructed by doctors
DELAYED REACTION
CLINICAL CAUSES
MANAGEMENT
Syphilis
Penicillin therapy
Malaria
Proper blood screening In case of malaria doner should be asked if he has cold,flu or foreign travel
PATIENT
Previous allergic reaction Consent Name and phone number of a contact person in case of emergency
Check physicians order for Blood component, volume, and rate of transfusion
NURSE
Only trained and qualified nurses are allowed to perform the blood transfusion steps
NURSE
While sending blood sample for cross matching, check CLEAR and CORRECT Patient name, file number, room number, age, sex, department, bed number, date,time,nurse name and signature
NURSE
BEFORE receiving blood Doctor order Consent Patient assessment Pre medicate the PT.30min. before transfusion.
PREPARE THE EQUIPMENT Having equipment available saves time and facilitates the task.
Blood filter designed to trap fibrin clots ,broken blood cells and other debris that accumulate during blood storage
Multi-lead tubing
NORMAL SALINE
ICE BAG, WARM COMPRESSES
ASEPTIC TECHNIQUES
Before receiving blood or blood product IV cannula to be inserted & maintained at a KVO rate.
while receiving the blood nurse should verify client identity, blood group, RH compatibility.
Flow chart
Healthy donors Blood screening for infectious diseases. Blood compatibility RH Proper storage Antibody screening
DONORS
LABPRATORY STAFF
DURING
Instruct the client Remain with the patient-15min V/S every hour until 1hr after transfusion Blood components are infused within standard time limits ( 4 hours)
AFTER
Close observation to the pt. Proper dispose of IV tubing/bag Documentation
Identification of blood & blood products should be performed at the patients bedside by two LICENSED PROFESIONALS,QUALIFIED NURSES according to the facilitys policy.
Blood should be transported and transfused to only one patient at the time
Hand hygiene to prevents the spread of microorganisms . Gloves protect against accidental exposure to the patients blood.
If youre administering whole blood, gently invert the bag several times to mix the cells.
Start the administration slowly (not more than 25 to 50 ml for the first 15 minutes of transfusion
If no signs of a reaction appear within 15 minutes, youll need to adjust the flow clamp to the ordered infusion rate.
Then remember to reconnect the original I.V. fluid, if necessary, or disconnect the I.V. infusion.
Practice Pointers
Although some microaggregate filters can be used for up to 10 units of blood, always replace the filter & tubing if more than 1 hour elapses between transfusions.
In case of emergency, When administering multiple units of blood, use blood warmer to avoid hypothermia.
Blood has not been used within 30minutes must be RETURNED , if blood Transfusion exceeds more than 4hrs it should be DISCONTINUED to prevent the risk of BACTERIAL CONTAMINATION.