Blood transfusion

Blood Transfusion at a hospital setting

1. Blood Transfusion- Ensuring Quality Runs in the Veins of Our Clients Paddington T Mundagowa , MPH, BScN, Cert. M&E

2. Outline Blood basics Decision to transfuse Ordering blood/component Delivering to clinical area Pre administration Monitoring patient Complications of Blood Transfusion

3. Note! This presentation aims at: Ensuring proper: Collection Administration Monitoring of blood for transfusion Promoting safe & effective blood transfusion practice Highlighting key aspects of safe transfusion practices for qualified transfusionists

4. Blood Basics Whole blood consists of: RBC, WBC, platelets & plasma On average, an adult has about 5 liters of blood circulating throughout their system

5. Blood Transfusion Def : is the transfusion of the whole blood or its component e.g. blood cells or plasma from one person to another Involves 2 procedures Collection from donor Administration to recipient Blood/Component can be: Whole blood, Packed cell volume, Fresh frozen plasma, Platelets, C ryoprecipitate

6. Decision to Transfuse Patient’s record/ notes must contain order to transfuse Prescribed by the Doctor Prescription must specify blood component No. of units Any special requirements/instructions Explain & discuss reasons for transfusion with patient Obtain informed consent from client Where pre-transfusion is not possible Clinician can consent based on condition, risks &benefits

7. Ordering blood/component Clinician correctly identifies patient Take blood sample for grouping & crossmatch Label blood tube correctly Complete a Lab request form Record in the Lab samples register Ensure a patent IV catheter Send sample to lab & communicate

8. Delivering to clinical area Executed by qualified practitioner Take patient’s notes & clean receiver to the Lab Check & match patient identifiers on pack & notes/prescription Check for leaks, unusual discoloration, cloudiness/clots Record in the Transfusion register in Lab Deliver in a clean receiver Maintain storage conditions until transfusion (+2 to +6 C)

9. Pre-Administration Practitioner who collected the blood & another qualified practitioner correctly identifies the patient At bedside Check instruction & inform the patient Check & record Patient identifiers Blood groups Donation & expiry date on pack Pack No. Take & record baseline vital obs.

10. STOP! If any of the above criteria are not met, DO NOT start the transfusion Notify the hospital Lab immediately

11. Both practitioners sign on chart May prime using 0.9% Sodium Chloride ONLY DO NOT use if container is not intact or if the appearance is not normal return to Lab Note & record time put up Start transfusion within 30 minutes of removal from the Lab fridge Complete transfusion within 4 hours

12. Monitoring Patient Monitor Vital signs Quarter hourly (1st hour) Half hourly thereafter Monitor infusion rate Critically observe patient for adverse reactions Diagnose & swiftly respond to adverse reactions Record, report adverse reactions to the doctor assess need for further transfusion

13. Post Transfusion Record time of completion of transfusion Continue monitoring 6 hours post transfusion Keep used pack 24 hour post transfusion Report & document adverse reactions/incident Discard empty pack & giving set in a Biohazard container

14. Complications of Blood Transfusion Circulatory overload Hyperkalemia Hypocalcemia Haemosiderosis Hematoma Thrombophlebitis Pulmonary embolism

15. ?

16. Thank You