Blood transfusion (CPD) nursing students

blood transfusion

2. CONTENTS
Introduction
Purposes
Indications
Contraindications
Types of blood content
Preparation for blood transfusion
Nursing management
Risk and complications

3. INTRODUCTION
Bloodtransfusionistheprocessoftransferringbloodproducts
intoaperson'scirculationintravenously.
Bloodtransfusionshouldbeundertakenwhen:
•Hemoglobin(Hb)<7-8gm/dl(AmericanAssociationofblood
bank)
•Hb<10gram/dlandHematocritbelow30%forongoingbleeding
duringsurgeryortrauma(AmericanAssociationofbloodbank)
•Hb<6gm/dlalmostalwaysindication(WHO)

4. PURPOSES
Toreplacethebloodvolume
Toreplacetheneededcomponent
Tomeetthetargetlevelofbloodandblood
components

5. INDICATIONS
Lowproductionofblood
Majorroadtrafficaccident
Chronicbloodlosswithanemia
Conditionssuchas:bleedingdisorders,
malignancies,coagulopathies,majorsurgeries,
severeburn

6. CONTRAINDICATIONS
Wholebloodisnotindicatedwhen
componentspecifictherapyareneeded&
chronicanemia
Formegaloblasticanemia(VitaminB12
deficiency)transfusionmaycauseheart
failureordeath

7. TYPES OF BLOOD CONTENT
Wholeblood
Obtainedfromdonors&noneofelementshasbeen
removedorcombinedwithanticoagulant
Indication:Casesofseverehemorrhageandlow
hemoglobin,torestorebloodvolumeandwhenthereis
notimeforotherpreparation
Duration/shelf-life:35-42days
Storageandtransportationtemperature:+2°Cto+6°C
Transfusiontemperature:(37°c/98.6ºF)
Transfusionduration:2to4hours

8. TYPES OF BLOOD CONTENT
Packed red cells (packed red blood
concentration / PRBC) / RCC
Erythrocytesareseparatedfromwholebloodthrough
apheresisprocess
Indication:postopacutebleeding,chronicsevere
anemia,leukemia,thalassemia,congenital/acquired
anemicdisorders
Duration/shelf-life:35-42days
Storageandtransportationtemperature:+2°Cto+6°C
Transfusiontemperature:(37°c/98.6ºF)
Transfusionduration:2to4hours

10. TYPES OF BLOOD CONTENT
Plateletconcentrates
Platelets,orthrombocytes,aresmall,colorlesscell
fragmentsinourbloodwhosemainfunctionistostopor
preventbleeding
Indication:Bleedingduetoplateletsdysfunction,
Malignancy
Duration/self-life:4-7days
Storageandtransportationtemperature:+20°Cto+24°C
Transfusiontemperature:(37°c/98.6ºF)
Transfusionduration:1-2hours

11. TYPES OF BLOOD CONTENT
FreshFrozenPlasma(FFP)
Separatedfromunitofbloodwhichcontainswater,
electrolytes,coagulationfactors,andprotein
Indication:Totreatbleedingdisorder,forfactorv
deficiency,antithrombinIIIdeficiency,treatmentof
immunodeficiency
Duration/self-life:1year(storageconditionfrozen)
Transfusiontemperature:(37°c/98.6ºF)
Transfusionduration:1hour
FFP:noneedofx-match
FFPvolume-150-300ml

12. Preparation for blood transfusion
(Articles required)
A clean tray containing articles
For vein open : alcohol swab, torniquet, cannula
(16/18G), IV set, NS, adhesive tape, scissors,
roller bandage and splint if needed, IV stand
Vital signs: Blood pressure set, thermometer,
portable Saturation probe
Disposable bag/kidney tray, gloves, specimen
container
Different size syringe with needle (3ml,5ml,10ml)
Lifesaving drugs

13. Preparation for blood transfusion
(Articles required)

14. NURSING MANAGEMENT
BEFOREPROCEDURE
Identifythepatient
Checkthephysician’sorder,patientconditionandpast
historyoftransfusionreaction
Obtainbloodfrombloodbank
Explainpatientabouttheprocedure,needfortransfusionand
approximatelengthoftime
Obtaininformedconsentfromthepatient/patientparty
Bedsidecurtain/closethedoor

15. NURSING MANAGEMENT
BEFORE PROCEDURE
Wash and dry hands
Prepare required articles
Identify the patient’s condition by taking vital
signs and document pre-transfusion vital signs in
patients file
Check for type of blood and compatibility
Ensure the patient to empty bowel and bladder and
collect urine specimen
Keep the patient in comfortable position

16. NURSING MANAGEMENT
DURING PROCEDURE
Wash and dry hands
Vein open
Inspect the blood product by
2 nurses
•Patient’s name
•Blood group and type
•Collection date
•Expiry date
•Identification number
•Compatibility
•Abnormal color, clots

17. NURSING MANAGEMENT
DURING PROCEDURE
Warm blood if needed using special blood warmer
If blood product is found to be correct, stop the saline
solution and start the blood transfusion
Start blood product slowly at the rate of 2ml/ minute.
Remain at bedside for 15-30minutes,check the vital
signs every 15 minutes according to hospital policy
Increase infusion rate if no adverse reactions are
noticed.

18. RISK AND COMPLICATIONS
ACUTE REACTION DELAYED REACTION
Reaction occurring during the
transfusion or within 24
hours
Reaction occurring >24 hours
after the start of the transfusion
Can be seen up to 30 days of
post-transfusion
Symptoms : flushing,
urticarial, anxiety, vomiting,
headache, back pain, edema,
hives and itching
Symptoms : nausea, fever,
chills, chest and lower back
pain, and dark urine

19. Urticaria

20. If complication occurs
Stop the transfusion immediately
Start IV fluid
Consult duty doctor
Send both recipient and donor blood specimen
for repeat grouping and X matching
Most allergic reactions, this can be treated with
antihistamines
Monitoring the patient's vital signs before and
during the transfusion is important to identify
reactions promptly

23. REFERENCES
Continuousprofessionaldevelopmentmodulefornurses,Nursingand
Socialsecuritydivision,DoHS,MoHP,2020.
College,U.,2023.Step-by-StepMaster’sGuidetoBloodTransfusions.
UnitekColl.URLhttps://www.unitekcollege.edu/blog/a-step-by-step-
guide-to-blood-transfusion/(accessed12.26.23).
BloodTransfusionReaction-anoverview|ScienceDirectTopics[WWW
Document],n.d.URLhttps://www.sciencedirect.com/topics/medicine-and-
dentistry/blood-transfusion-reaction(accessed12.29.23).
Bloodtransfusion:Types,purpose,procedure,andrecovery,2020.
URLhttps://www.medicalnewstoday.com/articles/327513(accessed
12.26.23).
fresh-frozen-plasma-factsheet-april-2021-v5.pdf,n.d.
BloodComponents,URLhttps://www.redcrossblood.org/donate-
blood/how-to-donate/types-of-blood-donations/blood-components.html
(accessed12.27.23)