Blood Transfusion

BLOOD TRANSFUSIO N Introduction of blood or its component directly into the circulatory

INDICATIONS Blood

loss

Correct Surgery

Physiologic disorders

TYPES OF BLOOD 

Type A  Has



Type B  Has



A antigen and has anti-B antibodies

type B antigen and has anti-A antibodies

Type AB  has

both A and B antigen and has no A or B antibodies, universal recipient



Type O  Has

no A or B antigen, and has both A and B antibody, universal donor

COMPONENTS OF BLOOD

NURSING CONSIDERATIONS PRIOR TO BT 

Check doctor’s order  Cross

matching, blood typing

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Obtain consent

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Obtain history of allergy and fluid status

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Prepare and provide checklist

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Vital signs, pre-BT, intra BT, post-BT  baseline

then Q15 x 4; Q30 x 2; then q h

EQUIPMENTS 

Blood product

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G18 needle, sterile

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0.9 NaCl (Plain NSS)

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Blood transfusion test with filter

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Venipuncture set

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Gloves, tape, alcohol swab

PROCEDURE 

Get pre-transfusion vital signs

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Determine previous blood transfusion reactions

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After label is checked by the physician, With another nurse, verify: client’s identity  Blood unit labels and expiration  Blood group and Rh compatibility 

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Set-up the infusion set  Close

all the clamp on the Y set, the main flow rate clamp and both Y-line clamp  Spike in twisting motion  Hang on the container on the IV pole about 1meter or 3 feet

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Start the saline solution, attach the blood tubing primed with NSS to the intravenous catheter

Prime drip normal saline and flush IV line with normal saline to prevent blood from mixing dextrose solution  Invert the blood bag gently several times to mix cells with the plasma, pull the tab and spike the Y set 

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Infuse slowly for 1st 15 minutes at 10gtts/min, severe blood transfusion reactions occurs within 15-20 minutes of transfusion or within the transfusion of 100ml of blood

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Stay with the client within 15 minutes, monitoring vital signs every 5 minutes, noting for ractions. Altered vital signs is the early sign of blood transfusion reaction.

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After 15 minutes without noticeable reaction, adjust to consume blood products within ordered duration

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If any reaction, STOP THE INFUSION OF BLOOD, maintain infusion of NSS and notify physician

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Obtain blood (patient’s blood and the transfusing blood) and urine and send to laboratory per doctor’s order

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After transfusion, open normal saline and infuse ubtil tubing is clear

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Blood should be transfused within 4 hours from the laboratory, as it is “old blood” rising hyperkalemia

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Document relevant data  Reactions  Vital

signs  Blood information  #of blood to transfused  Drip rate  Time started and finished

TRANSFUSION REACTIONS 

Febrile reactions:    

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Allergic reactions    

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Fever Chills Headache Body malaise Flushing Urticaria Wheezing Rashes

Hemolytic reactions      

Facial flushing Chills Low back pain Hypotension Hematuria Anaphylactic shock