BLOOD TRANSFUSION

NUR 317

TRANSFUSION

• Infusion of blood products for the purpose of restoring circulating volume.

• May be whole Blood or blood components• Platelets

• Plasma

• PRBC

• Albumin

Administering Blood Products

• Leukocyte-free PRBC: • Most WBCs removed to reduce risk of reaction

• Whole blood: • Most common blood product given in the hospital

• Used to treat shock, low blood volumes, low hematocrit and hemoglobin, hemorrhage

• Packed RBCs:• Separated from plasma

• Used to treat anemia, and reduce risk of volume overload

Administering Blood Products

• Fresh frozen plasma (FFP): • Used to restore plasma volume, treat some bleeding

problems

• separated from whole blood by a centrifuge process

• Platelets• Maintain normal coagulability of blood

• Used to treat some bleeding disorders, and to compensate when marrow can not produce enough

Blood Supply Safety

• Once blood has been received from the donor it is immediately tested for blood type and infectious diseases

Type and Crossmatch

• Blood undergoes “type and crossmatch”: • Typing to determine ABO and Rh factor

• Crossmatching to determine compatibility between donor and recipient blood

• ANTIGEN: is a substance that prompts the generation of antibodies

• ANTIBODY: are proteins that are found in blood and are used to identify and neutralize foreign objects, such as bacteria and viruses

4 types

• A

• B

• AB

• O

Blood Typing

• The Rh factor is made up of numerous complex antigens • When it is present, the person is Rh positive (Rh+); if not

present, the person is Rh negative (Rh–)

Blood Typing

• An Rh positive person may receive either – or + blood

• An Rh negative person must receive only Rh– blood • If an Rh– person receives Rh+ blood, antibodies will form

• If another transfusion of Rh+ blood is given, the antibodies will agglutinate with the Rh antigens of the blood being transfused

Blood compatibilities

Blood typing for transfusion

• Universal donor= O-• Does not contain A, B, or Rh antigens

• Universal recipients= AB+• Blood contains A, B, and RH antigens

• Usually blood banks exactly match the pt blood

Blood Screening

• Prior to be being released for patient use

• testing for:• Hepatitis C

• Human immunodeficiency virus (HIV)

Infusion Therapy Risks• Risk factors:

• Disease transmission• Hepatitis B

• Hepatitis C

• Hepatitis A

• HIV

• Syphillis

• Bacterial contamination

• Acute or delayed transfusion reactions• Allergic reactions

• Mismatched ABO

• Incompatible Death

• Circulatory overload

Infusion Therapy Hazards

• Some risks specific to massive transfusion (replacement of > one blood volume in 24 hours):

• Hypothermia

• Hemodilution

• Platelet dysfunction

• Electrolyte problems

ADMINISTRATION PROCESS

• ASSESS Transfusion history• Previous transfusions, allergies and reactions

• Type of transfusion reaction, manifestations, and treatment

Interventions

• Once the blood has been taken from the blood bank, it must be administered within 30 minutes

• The nurse must ensure: • Positive patient identification

• Appropriateness of blood component

• Blood product inspection

• Verification of donor – recipient compatibility

• Verification of product expiration date

administration of blood

• 18 or 20 gauge IV canula

• blood needs to be checked by 2 licensed nurses.

• Check expiration date, name, medical record number, type of blood, blood band id, pt age

• Check vitals prior to administration

• **blood must be initiated with in 30 minutes of arrival from bank to floor

• Use blood tube for administration

• Monitor for blood reactions

• Monitor vitals continuously during administration

• Circulatory overload: • Dyspnea

• Tachycardia

• Cough

• frothy sputum

• Cyanosis

• increased BP that drops suddenly

• distended neck veins

• crackles

Y-type blood tubing