Blood Transfusion
Blood Transfusion
Blood Transfusion
BLOOD
A mixture of cells A complex TRANSPORT mechanism
Transports hormones Removes waste products Regulates body temperature Protects the body Promotes hemostasis Supplies oxygen
BLOOD VOLUME
!" of total body weight = varies by age & body composition
Blood Volume
#OMPOS$T$ON O% BLOOD
Temperature 38 !"##$%&' p( )$3* + )$%* ,pecific -ravity "$#%8 "$#.. /ody weight )0 * times the viscosity of water 1olume
2ale &emale * . 3iters % * 3iters
Plasma
Li(uid )art of the blood onsists of serum and 'ibri&o*e& ontains plasma proteins such as4
Albumi& = regulates & maintains Serum *lobuli&s = for transportation %ibri&o*e&+ )rothrombi&+ )lasmi&o*e& = to stop the bleeding
#ellular #om)o&e&ts
%ormed eleme&ts o' blood
RB# = responsible for oxygen transport
TRANS%US$ON
6efers to the admi&istratio& of any of several blood products$
7s li'esa0i&* thera)/ for patients with a variety of medical and surgical conditions in need for blood$
BLOOD TRANS%US$ON
Assure that i&'ormed co&se&t has been obtained be'ore starting a transfusion$ Appropriate i&'ormatio& to include in patient education includes4
Be&e'its Ris6s Alter&ati0es to tra&s'usio&
NURSES MUST BE
Docume&t all )atie&t educatio& re*ardi&* tra&s'usio& thera)/= and the responses of patients and family members after teaching$
Patie&t Educatio&
Pro0ide )atie&t a&d 'amil/ i&'ormatio& to blood tra&s'usio& thera)/
The &eed for blood transfusion Ad0a&ta*es of blood transfusion Possible reactio&s related to the blood transfusion therapy Volu&tar/ blood do&atio& act
Do&5t add medicatio&s to the blood$ Do&5t tra&s'use the blood product if you discover a discrepancy in the blood number= blood slip type= or patient identification number$
Tra&s'usio& Precautio&s
,hows cha&*es in vital signs 7s d/s)&eic or restless <evelops chills= hematuria= or )ai& in the flan:= chest or bac:
BE%ORE TRANS%US$ON
8hen you received the delivery from the blood ban:= you should receive both the )roduct and the tra&s'usio& record that corresponds to it$ $&s)ect 'or the 'ollo.i&* Labels $&te*rit/ o' U&it A))eara&ce
?erform the verification process to ensure the correct blood is being given to the correct )atie&t$ T.o (uali'ied i&di0iduals should 0eri'/ the )atie&t a&d u&it ide&ti'icatio&3 Assess the )ate&c/ of the )atie&t5s 0ascular access3 #hec6 a&d rechec6 0ital si*&s 8B mi&utes after starting the transfusion$
DUR$N< TRANS%US$ON
Admi&ister the blood or component at the recomme&ded rate$ Sta/ with the patient for the first few minutes of the transfusion Re0ie. si*&s a&d s/m)toms of what the patient should report to you$
Disco&ti&ue tra&s'usio& immediatel/ o&ce the )atie&t ma&i'est s/m)toms o' tra&s'usio& reactio&+ assess the )atie&t a&d &oti'/ the doctor3 &inally= docume&t the tra&s'usio& i& the )atie&t5s chart$
A%TER TRANS%US$ON
ontinue to mo&itor )atie&t for any signs and symptoms of reaction for at least one hour after the transfusion$
Indications
"ursing Considerations
Dont infuse over more than 4 hours. Warm blood if giving a large quantity. Avoid giving when the patient ant tolerate the ir ulating volume. Dont infuse over more than 4 hours. #$%s have the same o!ygen " arrying apa ity as whole blood, minimi&ing the ha&ard of volume overload.
P#BC
To restore or maintain o!ygen " arrying apa ity To orre t anemia and surgi al blood loss
Indications
To treat thrombo ytopenia To treat a ute leu'emia and marrow aplasia
"ursing Considerations
A$( ompatibility isnt ne essary but is preferable with repeated platelet transfusions) #h type mat h is preferred. *nfuse +,, ml over +- minutes. Administer at +-, to .,, ml / hour, or as rapidly as the patient an tolerate) dont e! eed 4 hours. Avoid administering platelets when the patient has a fever. %ross " mat hing0 A$( ompatibility isnt ne essary but is preferable with repeated plasma transfusions) #h type mat h is preferred. 1arge " volume transfusions of 223 may require orre tion for hypo al emia. %itri a id in 223 binds al ium.
$$P
To e!pand plasma volume To treat postsurgi al hemorrhage or sho ' To orre t an undetermined oagulation fa tor defi ien y
SA%ET= PRE#AUT$ONS
2a:e sure that =OU are protected too by4
8ear proper Perso&al Protecti0e E(ui)me&t APPEC Always )er'orm disi&'ectio& tech&i(ue$ 7f possible= use a needleless system$ 7f using sharps= do &ot reca) the &eedle$ Always obser0e )ro)er .aste dis)osal according to your institution@s policy$ 7f there are spills= &e0er touch the blood .ith bare ha&ds$ 2a:e sure that blood bag is secured$ Always double or triple chec:$ Al.a/s )er'orm 7AND 7=<$ENE
Acute Tra&s'usio& Reactio&s usually appear within the first *+"* minutes after the transfusion is started$ T/)es o' Acute Tra&s'usio& Reactio&s
Acute hemolytic Transfusion 6eaction &ebrile nonhemolytic Transfusion 6eaction 2ild allergic !;rticarial' Anapylactic Transfusion Associated irculatory >verload Transfusion 6elated Acute 3ung 7n5ury ,eptic Transfusion 6eaction
W7AT TO DO $% TRANS%US$ON REA#T$ON O##URS 8hen they do occur= it is usually because of A/> incompatibility between patient and donor during transfusion of red cells$ Ensure that the intended recipient is getting the intended unit at the time of transfusion$
Should a&/ o' these s/m)toms occur+ disco&ti&ue the u&it immediatel/+ ha&* &ormal sali&e Ao& a &e. tubi&*C to mai&tai& 0ascular access+ a&d call 'or assista&ce3 #losel/ mo&itor the )atie&t5s 0ital si*&s a&d s/m)toms3 Noti'/ the )h/sicia& a&d obtai& 'urther orders to address the )atie&t5s s/m)toms3 Rechec6 the )atie&t5s ide&ti'/i&* i&'ormatio& a*ai&st the tra&s'usio& record a&d blood ba*3 All ba*s+ tubi&*s+ 'ilters+ a&d )a)er.or6 should be retai&ed a&d 'or.arded )er hos)ital )olic/3
7nfusion device used &low rate and if blood warming was used 1ital signs obtain prior to= during= and after the transfusion 9ame of the component= unit number Evidence of possible transfusion reaction$
<ocument interventions done and to whom you notified$
?atient@s outcome$