Blood component therapy

BLOOD COMPONENT THERAPY FOR NURSING STUDENTS

1. Blood Component Therapy Presented by Monika Devi Msc(N) HCN, SRHU

2. DEFINITION Blood transfusion is the IV administration of whole blood or its component such as plasma , packed red blood cells or platelets to correct or treat any clinical condition of a patient.

3. PURPOSES To increasing circulating blood volume . To increase the no. of red blood cells & to maintain hemoglobin level. To provide plasma clotting factors, to help in controlling bleeding. To combat infection due to decreased or defective white cells or antibodies.

4. INDICATION After surgery , trauma or hemorrhage . Severe anemia. Leucopenia (↓se WBC). Agranulocytosis (bone marrow does not produce enough or mature WBC)

5. BLOOD GROUP Blood groups & their respective agents. Group : AB A B O. The group O is universal “donor”. The group AB is universal “recipient “.

6. PRE-TRANSFUSION ASSESSMENT 1. Patient history of previous transfusion , reactions to transfusions , No. of pregnancies a women has , health problem , cardiac , pulmonary & vascular diseases. 2. Physical assessment – baseline vital signs , auscultation of lungs & patients use of accessory muscles , edema , jugular vein distention , skin rashes , echymosis , etc. 3. Patients teaching : patient should be taught about the sign & symptoms of adverse reactions.

7. PREPARATION OF RECIPIENT Explain the procedure to the patient & relatives Ask whether he/she has undergone prio transfusion & reactions Take informed consent from the patient/relative Provide comfortable position to the patient

8. CONT… Check & record the vital signs of the patient. Offer a bedpan before starting the procedure. Educate the patient about adverse reactions & ask her/him to report immediately

9. articles

10. PREPARATION OF ARTICLES A tray containing : A blood transfusion set A mackintosh & A towel A tourniquet , Cotton swabs with Antiseptic Adhesive tape & scissors , Gloves , kidney tray . IV stand NS, Paper bag , Blood or any of it components with cover received from blood bank with the name of recipient

11. Procedure Wash hands , wear gloves Perform vein puncture by selecting a large vein which allows the patients mobility. Check the blood to be transfused for group , Rh type , expiry date etc. Also inspect for abnormal colour , cloudiness , clot & excess air. Open the packing of blood transfusion set aseptically & insert infusion set into.

12. Cont.. Check the needle & solution of previous IV infusion whether they are appropriate for administering blood. The needle no.18 or 19 & solution must be NS. Put pressure by placing tourniquet 10-12 cm above insertion site & ask patient to clench fist Clean the insertion site with iodine & spirit. Insert the needle & start infusion with NS

13. Cont… Firstly identify blood product & patient thoroughly & the transfusion is begun For first 15 min adjust flow at 2ml/min & remain with patient . If any reaction is suspected , notify the physician Monitor vital signs every 5 min for first 15 min Observe for flushing , itching , dyspnea , rash or any other adverse reaction

14. Cont… Then infusion rate should be set as per physician’s order Remove & dispose of gloves, wash hands Record with date , time , blood group , adverse reactions & amount of blood infused 1 unit of blood contains 350ml of blood Preservative –citrate dextrose phosphate adenine

15. NURSING RESPONSIBILITIES Nurse is responsible for safety & effectively administering IV infusion . Nurse must have legal knowledge about infusion. Nurse should do through assessment of patients Physical condition , medical history , allergies & dietary pattern should be known by nurse

16. CONT… Nurse should have knowledge about calculation of flow rate & methodical approach . Nurse should apply physiological , anatomical & aseptic principles . Nurse should have vigilant observation throughout the procedure so as to prevent adverse reactions which can sometimes be fatal

17. COMPLICATIONS OF BT 1 . Hemolytic Transfusion Reaction :- Occurs due to incompatibility of blood, Incomplete storage of blood , Storage beyond 21 days , Warming of blood above 40◦C or by exposure of red cells to dextrose solutions It is indicated by fever , chills , head-ache , dyspnea , cyanosis , chest pain etc. There may be a drop in B.P. , oliguria or may cause anuria .

18. CONT… 2. Pyogenic Reactions : Its incidence gets decreased now a days due to use of disposable sets . It occurs when there are some external substances present in the tubing, characterized by fever with chills , nausea , vomiting , diarrhea , headache , backache , delirium , shock & renal failure

19. CONT… 3 . Allergic Reactions : There are due to individual sensitivity to plasma proteins characterized by itching , laryngeal edema & bronchial spasms 4. Circulatory Overloads : It occurs in people suffering from severe anemia , as they need only RBC’s , but when they receive the whole blood . Patients with heart failure are more vulnerable for circulatory overload

20. CONT… 5. Transmission of infectious diseases : Various diseases like hepatitis, AIDS , malaria , syphilis etc. are transmitted through blood when not properly checked. 6. Anaphylactic reactions : These occur rarely but are life threatening condition characterized by a severe respiratory & cardio-vascular collapse , severe GI disturbances

21. Cont.. Other complications :- hematoma at site of the needle Thrombophlebities. Pulmonary embolism.

22. Nursing management regarding complication of blood transfusion If occur : - Stop the transfusion immediately Notify the physician Connect the Iv line with 0.9% normal saline. Be with the client, observe the sign and symptoms and monitor the vital signs till they becomes stable.

23. Cont… Get ready the emergency drugs such as vasopressor , antihistamine, steroid, and fluids. Obtain a urine specimen and send to the laboratory. Save the blood container and tubing for return to the bank . Document the reactions and measures carried out.

24. Nursing responsibilities Nurse is responsible for safety and effectively administering i/v infusion. Nurse must have legal knowledge about infusion. Nurse should do through assessment of patients physical codition , medical history, allergies and dietary pattern. Nurse should have knowledge about calculation of flow rate and methodical. Nurse should apply physiological, anatomical and aseptic principles. Nurse should have vigilant observation through out the procedure so as to prevent adverse reactions which can sometimes be fetal.

25. summary

26. references Janne v. hickey the clinical procedure of nursing 6 th edition 2009, page no . 435-436. Annamma jacob, clinical nursing procedure . The art of nursing practice second edition 2010.page no .435.

27. THANK YOU