Blood and Blood Products Transfusiion

BLOOD & BLOOD PRODUCTS TRANSFUSION
BLOOD TRANSFUSION
1. Potentially life saving procedure that replaces blood lost during surgery or injury
2. Serve as a treatment for patients with illnesses that stifle their ability to naturally produce enough blood
cells for their bodies. Example: anemia, Leukemia and kidney diseases
3. Essential step for surgeries and other lifesaving measures
4. A routine medical procedure that deliveries blood into a patients body
RED BLOOD CELL TRANSFUSION may be given to patients who suffer from an iron deficiency (anemia). This would
boost a patients hemoglobin and iron levels while improving oxygen levels in the body
PLATELET TRANSFUSIONS are often administered to patients who suffer from Leukemia or other types of
cancer.This is because they may have lower platelet counts due to chemotherapy treatments. Other patients may
suffer from illnesses that stop the body from creating enough platelets. Because of this, they may receive regular
transfusions in order to stay healthy.
PLASMA TRANSFUSIONS provide vital proteins and other substances that are crucial to a patient’s overall health. It
is often administered to those with liver failure, severe infections or serious burns.
WHAT IS THE PURPOSE OF BLOOD TRANSFUSION?
1.Many patients who undergo a major surgical procedure will receive a blood transfusion to replace blood lost
during surgery
2.It is typically administered to patient’s who have suffered serious injuries from car crashes,natural disasters or
other traumatic events.
3.Patients who suffer from illnesses that cause anemia will typically require blood transfusions as part of treatment
and include illnesses such as leukemia or kidney diseases
HOW LONG DOES IT TAKE TOPERFORM A BLOOD TRANSFUSION?
Depending on the amount of blood a patient requires, a simple blood transfusion can take 1 to 4 HOURS.
The procedure starts when an intravenous (IV) line is placed into the patient’s body. With this IV, the patient can
receive new blood.
If the patient is receiving IV medication this IV line cannot be used as access for blood transfusion, there must be
another IV line for blood transfusion.
-Transfusion is within 20-30 mins. And must be done 2-4 hours inorder not to have bacteria and septicemia. And
the blood must be warm.
BLOOD BANK
-The patient’s ABO compatabiliy and RH Factors must be identified. That is the blood type of the patient.
Type O universal donor
Type AB universal recipient
NECESSARY EQUIPMENT FOR A BLOOD TRANSFUSION
IV access. Blood components may be provided through a number of central venous

access devices (CVAD) or peripheral intravenous catheters. You might want to
consider the below sizes.
 20-22 gauge for routine transfusions in adults.

 16-18 gauge for rapid transfusions in adults.
 22-25 gauge for pediatrics.
 Administration sets. The requirements for these sets might vary. Check the facility-
specific policy first.
 Sets for blood components. Administering blood components requires the use of a
blood filter, which may range in pore size from 170 to 260 microns. It’s intended
to remove clots, cellular debris, and coagulated protein.
 Sets for PPPs. The administration of platelet-poor plasmas (PPPs) may require a
number of supplies, which often differ by product and brand. Facilities should
refer to the product monograph and local policy to determine what filtration is
required.
 Infusion devices. Infusion devices can be used to transfuse blood components (i.e.
infusion pumps, rapid infusers, blood warmers, and pressure devices).
 Pressure infusion devices. A pressure infusion device may be used for the rapid
administration of blood components.
 Blood warmer devices. A blood warmer device is often used to prevent
hypothermia during rapid administration of cold-blood components, such as the
operating room or a trauma setting.
Potential Risks or Complications of a Blood Transfusion
While this is typically a low-risk procedure, serious blood transfusion risks or

complications can include some of the following conditions:
 Allergic reactions
 Fever
 Acute immune hemolytic reaction
 Blood-borne infections
However, the most common reaction to a blood transfusion is mild soreness around
the IV site.
You can avoid some of these adverse reactions by following the appropriate steps.
What they say is true: practice makes perfect.
Blood Transfusion Prep

Blood transfusions are often administered in a hospital, outpatient clinic, or doctor’s
office. A nurse or doctor will also check the patient’s blood pressure, pulse, and
temperature before starting the procedure.
Blood Transfusion Steps

Before the Transfusion
1. Find current type and crossmatch
 Take a blood sample, which will last up to 72 hours
 Send your sample to the blood bank
 Ensure the blood sample has the correct date/timing/labeling
 Wait for the blood bank to match and prepare needed units based on
the sample you sent them
2. Obtain informed consent and health history
 Discuss the procedure with your patient
 Confirm their health history and any allergies
 Ensure that the supervising doctor has acquired signature consent for
administration of blood products from the patient
3. Obtain large bore IV access
 This is 18G or larger IV access
 Each unit will be transfused within 2-4 hours
 Obtain a second IV access if the patient requires additional IV
medication therapy (i.e. antibiotics)
 Remember: Normal saline is the only solution that can be transfused
with blood products
4. Assemble supplies
 Special Y tubing with an in-line filter
 0.9% NaCl (Normal Saline) solution
 Blood warmer
5. Obtain baseline vital signs
 These include heart rate, blood pressure, temperature, pulse oximeter,
and respiratory rate
 Lung sounds and accurate urine output should also be documented
 Notify the doctor if their temperature is greater than 100° F
6. Obtain blood from blood bank
 Once the blood bank notifies you that the blood is ready, you must
schedule its delivery from the blood bank
 Packed red blood cells (pRBCs) can only be hung ONE UNIT AT A TIME.
 Remember: Once the blood has been released for your patient, you have
20-30 minutes to start the transfusion and up to 4 hours to complete the
transfusion
Initiating the Blood Transfusion

1. Verify Blood Product
 Two RNs at the patient’s bedside must verify the below:
 Physician’s order with patient identification compared to the
blood bank’s documentation
 Patient’s name, date of birth, and medical record number
 Patient’s blood type versus the donor’s blood type and Rh-factor
compatibility
 Blood expiration date
2. Educate the patient
 Relay the signs and symptoms of a transfusion reaction. If these occur,
the patient should notify their RN during the transfusion
 Rash, itching, elevated temperature, chest/back/headache, chills,
sweats, increased heart rate, increased respiratory rate, decreased
urine output, blood in urine, nausea, or vomiting
3. Assess and document the patient’s status
 Baseline vital signs (HR, RR, Temp, SPO2, BP), lung sounds, urine
output, and color
4. Start the blood transfusion
 Prepare the Y tubing with normal saline and have the blood ready in an
infusion pump
 Run the blood slowly for the first 15 minutes (2mL/min or 120cc/hr)

 Remain with the patient for the first 15 minutes; this is when most
transfusion reactions can occur
 Increase the rate of transfusion after this period if your patient is stable
and doesn’t display signs of a transfusion reaction
 Document vital signs after 15 minutes, then hourly, and finally, at the
completion of the transfusion
During the Transfusion
1. Look for any of these transfusion reactions

 Allergic
 Febrile
 GVHD (Graft vs. Host Disease)
 TRALI (Transfusion Related Acute Lung Injury)
2. If you suspect a reaction, do the following
 Stop the transfusion IMMEDIATELY
 Disconnect the blood tubing from the patient
 Stay with the patient and assess their status
 Continue to check for status changes every five minutes
 Notify the doctor and blood bank
 Prepare for further doctor’s orders
 Document everything
After the Transfusion

1. Flush Y tubing with normal saline
2. Dispose of used Y tubing in a red biohazard bin
3. Obtain post-transfusion vital signs and document the patient’s status
Blood Transfusion Recovery
After the procedure, patients may experience some soreness near the puncture site,
but this side effect should dissipate quickly. In addition, the patient’s doctor might
request a checkup after the transfusion.

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BLOOD & BLOOD PRODUCTS TRANSFUSION

WHAT IS THE PURPOSE OF BLOOD TRANSFUSION?

HOW LONG DOES IT TAKE TOPERFORM A BLOOD TRANSFUSION?

NECESSARY EQUIPMENT FOR A BLOOD TRANSFUSION

IV access. Blood components may be provided through a number of central venous

 20-22 gauge for routine transfusions in adults.

Potential Risks or Complications of a Blood Transfusion

While this is typically a low-risk procedure, serious blood transfusion risks or

Blood Transfusion Prep

Blood Transfusion Steps

Initiating the Blood Transfusion

During the Transfusion

1. Look for any of these transfusion reactions

After the Transfusion

Blood Transfusion Recovery

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