Blood transfusion

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1. BLOOD TRANSFUSION BY UMA J DEAVER

2. BLOOD TRANSFUSION

3. DEFINITION Blood transfusion is the intravenous administration of the whole blood or a component such as plasma, packed red blood cells or platelets to a patient.

4. Homologous transfusion:transfusion of blood that is take from the other human beings (donor) & stored. Auto logous transfusion:it is the refusion of a patient’s own blood Tranfusion of plasma expanders and blood components. THREE MODALITIES TO REPLACE BLOOD LOSS

5. To increase circulating blood volume To increase the number of red blood cells and to maintain the haemoglobin level. To provide plasma clothing factors, to help in controlling bleeding. To combat infection due to decreased or defective white cells or antibodies. PURPOSES

6. After surgery, trauma or haemorrhage Severe anaemia Haemophilia Leucopoenia Agranulocytosis Throblastosis fetalis INDICATIONS

7. It must not be outdated (21 days) Blood should be warmed to 35c before transfusion. Blood can be left ½ hr at room temperature. THINGS KEPT IN MIND

8. GROUP AGGLUTINOGENS IN THE RED CELLS AGGLUTINIS IN THE PLASMA AB A and B No agglutinins(-) A A Beta agglutinins (b) B B Alpha agglutinins (a) O No agglutinogens Both alpha & beta ( ab ) BLOOD GROUPS AND THEIR RESPECTIVE ANTIGENS

9. Should not be suffering from disease of heart, kidneys,liver,lungs,cancer,jaundice, tuberculosis, hepatitis, AIDS, allergies etc. Should not have donated blood within the previous 90 days. Should be healthy and in the age group o 18-65 years. Should not be pregnant. Should have HB level above 12gm% Should have normal vital signs (TPR BP) Should not be empty stomach. SELECTION OF DONOR

10. PREPARATION OF THE RECIPIENT Explain the procedure to the patient. Determine whether the patient has undergone prior transfusion and reactions,if any. Get an informed consent from the patient/ relation. Provide a comfortable position. Prior to administration of blood, the patient’s vital signs should be recorded correctly Check & Ask the patient to report chills, headaches,itching , or rash immediately so that prompt reporting and discontinuation of transfusion can be done. PROCEDURE

11. Wash hands, wear gloves Identify the accessible veins Check the blood to be transfused for group.(Rh type, expiry date,etc) Open the sterile packing of blood transfusion set aseptically Place tourniquet 10-12cm above the insertion site by asking the patient to clench his fist . Clean the insertion site with iodine or spirit. Insert the needle and start infusion . Begin transfusion after identify the blood product and the patient thoroughly. Adjust rate to 2ml/min for first 15 min , and remain with the patient Monitor vital signs every 5 min for first 15 min and every hour thereafter Remove and dispose of gloves and wash hands Record administration of blood ,date ,time ,blood group ,adverse reaction and amount of blood infused . STEPS OF PROCEDURE

12. Haemolytic transfusion reaction Pyrogenic reactions Allergic reactions Circulatory overload Transmission of infection diseases Anaphylactic reactions COMPLICATIONS OF BLOOD TRANSFUSIONS

13. It occurs within 1 to 2 hrs and within 24 hrs. It is rapid destruction of donor RBCs by host antibiodes ( IgG , IgM ) SIGN & SYMPTOMS:fever , hypotension, anxiety, and later sign red colour urine MANAGEMENT: Discontinue the blood transfusion Check BP for hypotension Prophylactic measures to reduce the risk of renal faiure as per doctor order. Hemolytic transfusion reaction:

14. It occurs within mints or upto 24 hrs SIGN & SYMPTOMS Fever, flank pain, redish brown urine, acute renal failure MANAGEMENT Check BP Prevent renal failure Infuse normal saline as per doctor order Maintain urine out put more than 100 to 200 ml/hr Cardiac monitoring ABC if needed Pyrogenic reaction