BLOOD TRANSFUSION

by: Juan Paolo G. Serame, BSN, RN

Blood Transfusion – is the introduction of whole blood or blood components into the
venous circulation.

Trivia:

1. Every three seconds someone needs blood. Blood and blood products are used to
treat accident and burn victims, cancer patients and other patients undergoing
surgeries and medical treatments.
2. Red blood cells can be stored for up to 42 days.
3. Platelets can be stored for only five days.
4. Frozen plasma can be stored for as long as one year.
5. Because blood donations often are separated into several “components” (red
blood cells, plasma and platelets, for instance), one donation can help save three
lives.

Blood – is a specialized bodily fluid that delivers necessary substances to the body's cells.
 Blood Groups

Blood Type Antigen Antibody Frequency

O -- A&b 44%

A A B 45%

B B A 8%

AB A&B -- 3%

Blood Products

Blood Products Use

1. Whole Blood Acute Hemorrhage

2. RBC To increase oxygen carrying capacity of

blood

3. Platelets Replaces platelets in clients with bleeding

disorder.

4. Fresh Frozen Plasma Expands blood volume and provides

clotting factors

5. Albumin and Plasma Protein Fraction Blood volume expander

6. Clotting Factors and Cryoprecipitate Used for clotting deficiencies.

Purposes:
1. to restore blood volume after severe hemorrhage
2. to restore the capacity of the blood to carry oxygen
3. to provide plasma factors

Equipments:
 • Unit of whole blood or packed RBC
• Blood administration set
• 250 ml of 0.9% PNSS for infusion
• IV Pole
• Venipuncture Set (# 18 or 19 gauge needle; # 15 for fast infusion)
• Alcohol Swabs
• Tape
• Clean Gloves

Implementation:

1. Prepare the client.

• Explain the procedure and its purpose to the client
• Instruct the patient to report promptly any sudden chills, dyspnea, and
other unusual symptoms
• Take vital signs

2. Obtain the correct blood component

• Check the physician’s order
• Check the client’s name and identification number, serial number and ABO
group and Rh type on the blood bag label, expiration date.
• Make sure that blood is left at room temperature for no more than 30 minutes
before starting the transfusion.

3. Verify the client’s identity.

• Ask the client’s full name
• Check the client’s armband

4. Set the infusion equipment

• Attach the blood tubing to the filter
• Hang the container on the IV pole about 1 meter (36 inches) above the IV site

5. Prime the tubing

6. Start the Saline Solution

7. Prepare the blood bag

• Invert the blood bag gently several times to mix cells with plasma

8. Establish the blood transfusion

9. Observe the patient closely for the first 5 to 10 minutes

• Run the blood for the first 15 minutes at 20 drops per minute.
 10. Monitor the client
• Check the vital signs of the client after 15 minutes
• Don’t transfer for more than 2 hours
11. Terminate the transfusion
12. Document relevant data.
Transfusion Reactions
Reaction
1. Hemolytic Reaction
2. Febrile Reaction
3. Allergic Reaction ( Mild)
4. Allergic Reaction
(Severe)
5. Hypervolemia
6. Sepsis
Clinical Signs Nursing Interventions
Chills, fever, headache, 1. Discontinue the
backache, dyspnea, transfusion
cyanosis, chest pain, 2. Keep the vein open with
tachycardia, hypotension normal saline solution
3. Send remaining blood
and patient’s sample blood
to the laboratory for repeat
cross matching
4. Notify the physician
5. Monitor vital signs
Fever, chills, warm, flushed 1. Discontinue the
skin transfusion immediately
2. Give antipyretics as
ordered
3. Notify the physician
Flushing, itching, uticaria, 1. Stop the infusion
bronchial wheezing 2. Notify the physician
3. Administer medication
(antihistamine) as ordered
Dyspnea, chest pain, 1. Stop the infusion
circulatory collapse, cardiac 2. Keep the vein open with
arrest normal saline solution
3. Notify the physician
4. Apply the CPR in needed
Cough, dyspnea, pulmonary 1. Place the client upright,
congestion (rales), with feet dependent
distended neck veins, 2. administer diuretics and
tachycardia, hypertension oxygen as ordered
3. notify the physician
4. slow the transfusion
High fever, chills, vomiting, 1. Stop the infusion
diarrhea, hypotension 2. send the remaining blood
to the laboratory
3. notify the physician
4. obtain a blood specimen
from the client for culture
5. administer IV Fluids,
antibiotics