1. Dr. Kareema Ahmed Hussein 2017 -2018
Blood Transfusion
Dr. Kareema Ahmed Hussein

2. Blood Transfusion.
is the infusion of whole blood from a healthy person in to a recipient's vein of sick person .
Administration of blood or one of its components through an intravenous line (IV)
Reaches patient’s blood vessels
and enters the circulatory
system

3. Type of blood transfusion
Recipient : The person who receive the blood from another person
Donor : The person who give the blood { donates } to another person
Type of blood transfusion
1-Indirect type :
Blood is infused after it has been collected from donor and processed this method is used most commonly . it's similar to giving I.V. in .
2- Direct type :
Blood is infused as it's taken from donor this method is rarely except in emergencies

4. Typing and cross matching: [Blood compatibility]
Before blood can be given to person it must be determined that the blood of the donor and the recipient are compatible. If they are no: clumping and hemolytic of the recipients blood cells will result .
Typing
The laboratory examination to determine person's blood type ABO.
Cross matching:
The process of determining compatibility between blood
specimens .
Antibody
A substance that causes the formation of antibodies .
Agglutinin
An antibody that causes a clumping of specific antigens

5. Purpose of a Blood Transfusion
Restore blood volume
Replace clotting factors
Improve oxygen carrying capacity
Restore blood elements that are depleted
Prevent complications

6. 4 types A B AB O

7. Blood Typing
Most people have two related inherited antigens – A and B – that form the basis for the ABO blood typing
Individuals with A antigen have type A blood
Individuals with B antigen have type B blood
Individuals with both A and B have type AB blood
Individuals with no antigen have type O blood

8. Antibodies with each blood type:
Blood type A: Has B antibodies
Blood type B: Has A antibodies
Blood type AB: Has no antibodies
Blood type O: Has both antibodies( A&B)
The Rh factor is made up of numerous complex antigens
When it is present, the person is Rh positive (Rh+); if not present, the person is Rh negative (Rh–)

9. Blood compatibilities

10. Blood typing for transfusion
Universal donor= O-
Does not contain A, B, or Rh antigens
Universal recipients= AB+
Blood contains A, B, and RH antigens
Usually blood banks exactly match the pt blood

11. Whole Blood Composition: Red Blood Cells White Blood Cells Plasma
Platelets
clotting Factors
Purpose:
Volume replacement
Increase oxygen-carrying capacity
Indications:
Significant blood loss (>25% blood lost, i.e. hemorrhage)
Newborn babies with hemolytic disease

12. Packed Red Blood Cells (RBCs)
Composition:
RBCs with little plasma
Some platelets and WBCs remain
Purpose:
Increase RBC mass and oxygen-carrying capacity
Assists the body to rid carbon dioxide and other waste products
Indications:
Symptomatic and chronic anaemia
Blood loss due to injury or surgery

13. Platelets Composition: Platelets Plasma Some of RBCs Some of WBCs
Purpose:
Helps to stop bleeding (restore clotting ability)
Essential for coagulation of blood
Indications:
Decreased platelet count
Hemophilia
Thrombocytopenia
Platelet dysfunction (End stage renal disease, DIC)

14. White Blood Cells (WBCs)
Composition:
WBCs or leukocytes suspended in 20% of the plasma
Purpose:
Increase number of WBC’s
Replaces WBC’s that are functioning abnormally
Indications:
Sepsis (not responsive to antibiotics)
Persistent fever
Granulo-cytopenia

15. Fresh Frozen Plasma Composition: Plasma All coagulation factors
Purpose:
Increase blood plasma
Replenish clotting factors
Indications:
Bleeding in patients with coagulation factor deficiencies.
Burn
Liver Failure
Severe Infection

16. Albumin Composition: Albumin Purpose:
Volume expansion leading to increased blood volume
Indications:
Hypo-protein-anemia
Burns
Shock
Trauma
Surgery
Infections

17. selection of blood donors
I -The accurate type .
2-The donor must be free from diseases ( hepatitis )
3-The donor must be free from allergies .
4-The donor must be free from chronic diseases
5-Some banks don't accept blood donor who has been immunized recently because of possible allergic reaction to the blood .

18. typing and cross matching: [Blood compatibility]
Before blood can be given to person it must be determined that the blood of the donor and the recipient are compatible. If they are no: clumping and hemolytic of the recipients blood cells will result

19. Nursing Implications Before transfusion: Check physician’s orders
Review hospital policy
Ensure informed and written consent is provided
Check laboratory values
Compatibility of blood type and Rh factor
Understand the indications and rationale
Verification procedure occurs with two
nurses
Inspect the blood product for discolouration, clots, leaking, or presence of bubbles

20. Before transfusion (con’t):
Check the unit number on the unit of blood and on the form
Check the expiration date and time on unit of blood
Ask client to state first and last name
Check patient’s identification number on wristband and record
Use a or 19 gauge needle or catheter to transfusion to prevent damage of red cells .
During the first 15 min. of transfusion the blood should be
administered slowly about drop/mL to avoid complications
Stay with the pt. at first 15 min . to observe complications that may occur.

21. During the transfusion:
Monitor vital signs closely during the blood transfusion
Inspect condition of IV site
Observe for signs and symptoms of a reaction
The rate is increased after the 15 in according to the physician's orders .
Don't administer medications through the blood line { it may cause hemolytic).

22. After the transfusion:
Dispose of materials/equipment
Observe patient for clinical improvements
Assess the laboratory values for effectiveness of transfusion
The nurse must check the pt. For at least min . after finshing

23. Documentation Verification procedure Type of blood Amount administered
Vital signs
Patient’s response to therapy

24. Infusion Therapy Risks
Risk factors:
Disease transmission
Hepatitis B 1:140,000
Hepatitis C 1: 225,000
Hepatitis A 1:1 million
HIV 1: 1.5 million
Syphilis 1: 1 million
Bacterial contamination
Acute or delayed transfusion reactions
Mis-matched ABO 1: 35,000
Incompatible Death Rate 1:600,000
Circulatory overload

25. COMPLICATION
1-Febrile Reaction: Recipients hypersensitivity to the blood
S/S fever ,chill, headache ,malaise,
Onset after first 30 min. —6hr
Management:
Stop immediately IV.
Continue IV normal saline.
Notify the physician
Monitor vital signs.(antipyretics as order.)

26. 2-Allergic reaction: Sensitivity to the plasma protein
s/s rash, itching onset during or I hr after
management:
Stopping the IV and continue IV normal saline
Antihistamine may be order.
Comfortable

27. 3-Hemolytic reactions: onest immediately donors blood is incompatible with the recipient blood
s/s facial flushing ,fever ,chills ,headache tachycardia,low BP ,blood in urine↑
4-Sepsis:blood contamination by bacteria or dioxin onset within 2hrs.
s/s chill ,vomiting ,diarrhea, low BP, shock

28. 5-circulatory overload: To rapid infusion expands the vascular volume more than patient heart can tolerate.
S/s dyspnea, cough ,anxiety ,tachycardia, tachypnea ,cracorthopnea ,high BP .
Management
I -Elevate patient head.
2-Notify physician .
3-Stop or slow IV
4-Give morphine and diuretics ,oxygen as order

29. Thank You