Blood transfusion

Blood transfusion

1. BLOOD TRANSFUSION

2. INTRODUCTION Blood transfusions can be life-saving in some situations, such as massive blood loss due to trauma, or can be used to replace blood lost during surgery. Blood transfusion is the process of transferring blood or blood-based products from one person into the circulatory system of another. Components of the blood early transfusions used whole blood, but modern medical practice commonly uses only components of the blood .

3. DEFINITIONS Assisting in transfusion of blood or blood products into vein using aseptic technique. Blood transfusion consists of administration of compatible donor’s whole blood or any of its components to correct/treat any clinical condition.

4. Lower 1965 First blood transfusion

5. Philip (1825) First human blood transfusion PHILIP(1865

6. Discovery of ABO type LANDESTEINER(1900)

7. PURPOSE OF TRANSFUSION Restore and maintain blood volume Improve oxygen carrying capacity of blood Replace deficient blood components and improve coagulation Not be be given “just to make the patient feel better”

8. CONTINUED; To raise the hemoglobin level in cases of severe anemia which are not corrected by the administration of vitamins and iron therapy. To treat deficiencies of plasma proteins, clotting factors and hemophilic globulin etc. To provide antibodies to those persons who are sick and having lowered immunity by giving blood or plasma. To replace the blood with hemolytic agents with fresh blood as in case of erythroblastosis foetalis, hemolytic anemia. To improve the leucocytes count of blood as in agranulocytosis. To combat infection in patients with leucopenia

9. Type of Transfusion ： Whole Blood Blood Componen t RBC,PLT,CLT Plasma Substitutes Blood Transfusion

10. Symptomatic anemia (providing oxygen-carrying capacity) Shelf life =42 d (1-6 ℃) Red Blood Cells

11. Coagulation factor deficiencies 1 ml increases 1% clotting factors Being used as soon as possible After use of 5 U of RBCs, matching 2 U of FFP Fresh Frozen Plasma (FFP)

12. Thrombocytopenia (< 50,000) Platelet dysfunction Each unit increase 5,000 PLTs after 1 H Platelets

13. Indication ： Acute massive blood loss Anaemia Overwhelming Infection Dysfunction of Coagulation Any illness Blood Transfusion

14. EQUIPMENT Iv stand Injection tray Blood bag Blood giving set Surgical towel K-basin Tourniquet Adhesive and scissors Disposable gloves Normal saline

15. Double Check: Name, Type and Crossmatch Storage Time: Citrate Phosphate Dextrose Acidic Citrate Dextrose 21D, 35D Stored temperature: 1to 6 degree Celsius. No any other Medication ： Observation during / after Transfusion ： Attention ： Blood Transfusion

16. BEFORE ADMINISTRATION Informed consent Patient’s name, number, blood type Blood bag ID number Compatibility test results Expiration date C H E C K

17. BEFORE ADMINISTRATION Ask another person to check all information According to hospital policy Sign confirmation slip / transfusion record V E R I F Y Return unit to blood bank if any discrepancy exists

18. COMPATIBILITY RECIPIENT COMPATIBLE RED BLOOD CELLS COMPATIBLE PLASMA O O O, A, B, AB A A, O A, AB B B, O B, AB AB AB, A, B, O AB

19. Technique of Transfusion: Approach Route: P eripheral Vein, Center Vein Filtration before Transfusion ： Velocity of Transfusion ： 5-10ml/min Blood Transfusion

20. TRANSFUSION FLOW RATE Red blood cells : Initial rate no more than 25 ml in first 15 mts. Usual transfusion time is 2hrs & maximum time is 4hrs. Platelets 10 ml/min Plasma 10 ml/min Cryoprecipitate 10ml/min

21. START THE TRANSFUSION Obtain baseline vital signs Blood pressure Temperature Heart rate

22. START THE TRANSFUSION Prime filter Set flow rate to 5-10 ml/minute for first 15 minutes . Monitor vital signs for the first 15 mts /hour If no adverse effects are noted adjust flow to faster rate

23. POST PROCEDURE CARE Monitor vital signs every 30 minutes and watch closely for any undue reaction. Maintain the patient’s comfort during and after procedure. Dispose of used materials properly. Document procedure in patient’s medical record including patient assessment findings and tolerance to procedure. Monitor patient for response to and effectiveness of the procedure

24. I ncidence ： 2% Chills, Fever 39-40 . C Headache, S weatiness Nausea, Vomiting, Flushing 15min-1hr Febrile Reactions ： Transfusion Reactions

25. Burning at the intravenous (IV) line site Fever, Chills, Dyspnea Shock Cardiovascular Collapse Hemoglobinuria, Hemoglobinemia Renal Failure DIC Hemolytic transfusion reactions Transfusion Reactions

26. Massive transfusion complications : Volume Overload Congestive Heart Failure Tachycardia Tachypnea Cyanopathy Transfusion Reactions

27. CIRCULATORY Due to improper Component Dosage Seen with Whole blood, plasma S & S Headache, dyspnea, heaviness in limbs

28. SEPTIC Due to improper Storage Processing Seen with Platelets S & S Fever, chest pain, headache

29. WATCH FOR….. Fever Chills Headache Nausea Dyspnea Facial flushing Anxiety Hypotension Itchiness Chest pain

30. TERMINATING TRANSFUSION Flush tubing with saline Take vital signs Complete transfusion record Pack tubing, filter, blood bag Assess patient and make notes Return to blood bank

31. GENERAL INSTRUCTIONS Rate of flow should be slow for the first 10 minutes. If there are no signs of reaction, transfusion rate may be increased to required rate. Rate of flow must be slower for elderly patients and those who have heart disease If there are signs of complications, stop transfusion immediately. keep IV line open by connecting normal saline and notify doctor. Change transfusion set if another unit of blood/blood components is to be given Do not add medications to blood/blood components. Do not store blood/blood component in ward. Keep emergency drugs(e.g. Antihistamines,lasix,hydrocortisone,adrenaline.t.c) ready at hand

32. CONCLUSION: Administration of blood and blood components requires knowledge of correct administration techniques and possible complications. It is very important to be familiar with the agency’s policies and procedures for transfusion therapy.  

33. THANKS FOR YOUR ATTENTION