Blood Transfusion

ADMINISTERING BLOOD AND BLOOD COMPONENTS EQUIPMENT • • • • • • •

Tourniquet Iodine-containing skin antiseptic Needle or venous catheter Y-type blood infusion set 170-µ filter Normal saline Blood product as described

PROCEDURE

Nursing Action Rationale Preparatory phase 1. Inform the patient of the procedure, blood product to be given, approximate length of time, and desired outcome. 1. Instruct the patient to report unusual symptoms immediately. 2. Obtain and record baseline vital signs. 2. If the patient's clinical status permits, delay transfusion if baseline temperature is greater than 101.7° F (38.7°C). 3. Prepare infusion site. Select a large vein that allows patient some degree of mobility. Start the prescribed I.V. infusion. 3. Antecubital veins are not recommended for lengthy infusions. Prolonged restriction of arm movement is uncomfortable and inconvenient for the patient. In the event of an acute reaction, the I.V. catheter should be maintained with normal saline. DRUG ALERT Crystalloid solutions other than 0.9% saline and all medications are incompatible with blood products. They may cause agglutination or hemolysis. 4. Obtain blood product from blood bank.

P.966 P.967 Nursing and Patient Care Considerations • • •

Infuse at the prescribed rate. Generally, a unit can be given to an adult in 90 to 120 minutes. Pediatric patients are usually transfused at a rate of 2 to 5 mL/kg per hour. To reduce the risk of bacterial contamination and sepsis, RBCs must be transfused within 4 hours of leaving the blood bank. Observe closely (particularly during first 15 to 30 minutes) for the most common acute complications associated with packed RBCs, allergic and febrile transfusion reactions. Signs and symptoms of the more serious, but rare, hemolytic transfusion reaction are usually manifested during infusion of the first 50 mL