1. BLOOD TRANSFUSION

2. Purpose of Blood Transfusion To restore circulating blood volume To improve oxygen carrying capacity To correct single and multiple clotting deficiencies To maintain Hemostasis Hemostasis – is the process in which the normal and expected clotting factors occur to prevent defects in vascular integrity and to maintain normal fluidity of the blood.

3. PROCEDURE 1. Verify doctor’s written prescription and make a treatment card according to hospital policy 2. Observe ten (10) Rights when preparing and administering any Blood and Blood components. 3.Explain the procedure/rationale for giving blood transfusion to reassure patient and significant others and secure consent. Get patient’s history regarding previous transfusion. 4. Explain the importance of the benefits on Voluntary Blood Donation (RA 7719- National Blood Service Act of 1994) 5. Request prescribed blood/blood components from blood bank to include blood typing and cross matching and blood result to transmissible disease. 6.Using a clean lined tray, get compatible blood from hospital blood bank. 7.Wrap blood bag with clean towel and keep it at room temperature. 8.Have a doctor and nurse assess patient’s condition. Counter check the compatible blood to be transfused against the cross matching sheet noting ABO grouping and RH, serial no. Of each blood unit, and expiry date with the blood bag label and other lab blood exam as required before transfusion (Hgb and Hct.)

4. PROCEDURE 8.Have a doctor and nurse assess patient’s condition. Counter check the compatible blood to be transfused against the cross matching sheet noting ABO grouping and RH, serial no. Of each blood unit, and expiry date with the blood bag label and other lab blood exam as required before transfusion (Hgb and Hct.) 9. Get the baselin vital signs –BP, RR, temperature before transfusion. Refer to MD accordingly. 10. Give pre-med 30 minutes before transfusion as prescribed. 11. Do hand hygiene before and after the procedure. 12.Prepare equipment needed for BT (IV injection tray, compatible BT set, IV catheter/needle G 18/19, plaster, tourniquet, blood component to be transfused, Plain NSS 500cc, IV set, G 18 needle (only if needed), IV hook, gloves, sterile gauze 2x2 or transparent dressing, etc. 13. If main IVF with dextrose 5% initiate an IV lien with appropriate IV catheter with Plain NSS on another site,anchor catheter properly and regulate IV drops. 14.Open compatible blood set aseptically and close

5. PROCEDURE 14.Open compatible blood set aseptically and close roller clamp. Spike blood bag carefully; fill the drip chamber at least half full; prime tubing and remove air bubbles ( if any). Use needle G 18 or 19 for side drip (for adults) or of 22 for pedia (if blood is given through Y injection port, the gauge of needle is disregarded) 15.Disinfect the Y-injection port of IV tubing (Plain NSS)and insert the needle from BT administration set and secure with adhesive tape. 16. Close roller clamp of IV fluid of Plain NSS and regulate to KVO while transfusion is going on. 17. Transfuse the blood via the injection port and regulate at 10-15 gtts. Initially for 15 minutes and then at the prescribed rate (usually on the patient condition) 18.Observe patient for 10-15 minutes for any immediate reaction. 19.Observe patient on an on-going basis for any untoward signs and symptoms such as flushed skin, chills, elevated temperature, itchiness, urticaria, and dyspnea. If any of these symptoms occurs stop transfusion, open the roller clamp of the IV line with Plain NSs, and report to doctor immediately

6. PROCEDURE 20.Swirl the bag hourly to mix the solid with plasma. 21. When blood is consumed, close the roller clamp of BT, and disconnect form IV lines then regulate the IVF of plain NSS as prescribed. 22.Continue to observe and monitor patient post transfusion for delayed reaction could still occur. 23.Recheck Hgb and Hct, bleeding time, serial platelet count within specified hours as prescribed and/or per institution’s policy. 24.Discard blood bag and BT set adn sharps according t Healt Care Waste Management (COH/DENR) 25. Document the procedure, pertinent observations and nursing intervention and endorse accordingly. 26. Remind the doctor about the administration of Calcium Gluconate if patient had several units of blood transfusion (3-6 more units of blood).

7. Understanding Transfusion Therapy Who can and can’t give Blood Eligible Eligible Donor Must: Be at least 17 years of age Weigh at least 110 lb(50 Kg) Be free for skin disease Not have donated in the past 56 days Have a hemoglobin level of at least 12.5 g/dL(women) or 13.5 g/dL (men)

8. Understanding Transfusion Therapy Who can and can’t give Blood Ineligible Ineligible Donors include those: Who have Human Immunodeficiency Virus or Acquired Immunodeficiency Syndrome Who have taken illegal drugs I.V. Who have had sex with prostitutes in the past 12 months Who have had sex with anyone above categories Who have had hepatitis With certain types of cancer (other than minor skin cancer) With hemophilia Who have received clotting factor concentrations Who have recently traveled outside the United States