1. Blood Transfusions 1

2. Blood Administration Blood transfusion includes any of the following : whole blood packed RBC’s plasma platelets Purpose: 1.Increase blood volume 2.Treat anemia 3.Replace blood components (clotting factors, platelets, albumin)

3. IV Therapy: Blood Administration Blood Grouping “ O” is universal donor AB is universal recipient A blood B blood Rh factor If mismatched, transfusion reaction may occur (mild  severe)

4. Blood Types 4

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6. Administration of Blood Determine if patient knows the reason for the blood transfusion ◦Have they had a previous blood transfusion? ◦Have they had a previous blood transfusion reaction? ◦Is the blood transfusion consent signed? Take baseline vital signs 6

7. Administration of Blood Two RN’s must verify the blood ◦Blood components delivered are the ones that were ordered ◦Blood delivered to the patient is compatible with the blood type listed in the medical record ◦Right patient receives the blood ◦Checks medical record number ◦Checks the patient’s identification number ◦Checks the blood type ◦Checks the patients name 7

8. Administration of Blood Prepare the IV tubing. Blood is hung with normal saline (0.9% NS) ONLY 8

9. Administration of Blood Infuse the blood slowly Stay with the patient for the first 15 minutes and monitor for side effects. Take Vital signs after the first 15 minutes and at the end of the transfusion. Remember Blood is ideally transfused in 2 hours, but time can be lengthened to 4 hours if the patient is at risk for fluid overload. Beyond 4 hours there is risk for bacterial contamination. 9

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11. Acute Hemolytic Reaction Signs and Symptoms 11 Incompatibility to antibodies causing RBC breakdown

12. IV Therapy: Transfusion Reactions Febrile nonhemolytic: Sensitization to specific blood components Signs & Symptoms: Cause: antibodies against donor WBCs Mild allergic: sensitivity to plasma proteins Signs and Symptoms:

13. Transfusion Reactions Anaphylactic: reaction to blood proteins Signs & Sx:

14. Transfusion Reactions Circulatory Overload: fluid administered faster than the circulation can accommodate Signs & Sx: Sepsis: contaminated blood Signs & Sx: 14

15. Nursing Actions for Transfusion Reactions Stop the transfusion IMMEDIATELY Keep the IV line open Do not turn off the blood and simply turn on the 0.9% saline Notify HCP Remain with the patient, observing signs and symptoms and monitoring vital signs as often as every 5 minutes Save the blood container and tubing 15