Blood Transfusion
Introduction
Blood transfusion is the replacement of blood or its
components.
Or
Blood transfusion is a life saving procedure to place
the blood cell or blood products which lost through
hemorrhage, anemia and other disease.
Indication for Blood Transfusion :-
Hemorrhage
Anemia
Trauma
Burns
Surgery
Types of Blood Donation :-
1. Autologous
2. Blood Salvage
3. Designated Donor
1. Autologous :-
• "Blood Donate to Yourself" (Donating Blood to
Yourself))
• In this type of blood donation, before any schedule
procedure, the patient's own blood is donated and
restored (so there is less risk of disease transmission
and transfusion complication).
• Collect and restore Blood before 5 weeks from
Scheduled Procedure.
• This type of blood transfuse is not possible in a
patient with septicemia and leukemia. ,
2. Blood Salvage :-
• Blood salvage is also the type of Autologous Blood in
this by Suctioning Blood Collect from body cavities,
Joint Spaces and other closed body sites
• Before re-infusion of blood, the blood is used by
special process.
3. Designated Donor :-
• Compatible donor selected by Recipient.
Types of Blood Components :-
1. Whole Blood :-
• 1 Unit = 350 ml ( 300 ml Blood + 50 ml Anticoagulant )
• Maximum Storage time :- 35 Days
•Storage Temperature :- 1℃ - 6℃ ( Ideal Storage temperature
4℃ )
•Infusion time :- 2 - 4 hour
•Note :- Blood Transfusion is always do with in 4 hour, because
of which Septicemia (Blood Bacterial) Infection) chance can be
prevented.
• Discard Blood remains after 4 hours of Blood Transfusion.
2. Red Blood Cells [ RBC ]
• 1 Unit = 250 ml ( 1 Unit RBC Increase 1 Gram
hemoglobin )
• Maximum storage time = 42 Days
• 2 - 3% Hematocrit Value increase
• Transfusion time :- 2 - 4 hour
3. Platelets
• Platelets Transfuse in thrombocytopenia and Platelets
dysfunction.
• 1 Unit = 50 - 70 ml
• 1 Unit Platelets Increase 5000 - 10,000 cells platelets /
mm3
• Maximum Storage time :- 5 - 7 Days ( Mainly 5 days )
• Effective use as soon as Transfer.
• Storage Temperature = 20° - 24℃
• Transfusion time = 15 - 30 Minute
4. White Blood Cells ( WBC )
• 1 Unit = 400 ml
• Transfusion time = 1 Hour (WBC is not stored)?
• Use :- immunity Deficient Person and Chronic
Infection Person.
5. Fresh Frozen Plasma [ FFP ]
• Transfuse In :- Deficiency of Blood clotting factor
( V , VIII ) and Plasma Protein.
• 1 Unit FFP = 200 - 250 ml
• Storage Time - 1 Year
• Storage Temperature :- -30℃ for 1 Year Store
• -60℃ for 2 Year Store
• Transfusion Time :- Within 15 - 30 minutes.
Types of Plasma Products
(1) Albumin :-
• Use in Hypovolemia Shock, Liver failure,
hypoalbuminemia.
• Stored for 5 Years.
• 25 gm/100ml is equal to 500 ml of plasma.
(2) Cryoprecipitate
• Prepared from FFP, used to Replace clotting factors
VIII and XIII, Fibronectin and Von Willebrand factor.
• Used for Bleeding Disorders
• Store - Can be Stored for 1 Year.
• 1 Unit Administered over 15 - 30 minutes.
• Note :- Client's medical record complete information
about blood transfusion To document
Compatibility
• Client's Identification ( Name on Band or Bracelet )
• Recipient ABO type & Rh type Identify
• An antibody screen :- Presence of Antibody
• Universal Blood Donor :- O-ve
• Universal Blood Recipient :- AB+ve
Conditions for Blood Donation
• Donor must be free from all Infectious Disease like
malaria, HIV, Hepatitis, STD etc.
• Donor should not be donated blood in last 90 days.
• Age will be Between 18 - 65 year.
• Hemoglobin not less than 12gm%.
• Blood Should not be collect in Empty Stomach.
• Give Sweet drink to donor after Donation.
Precautions for Blood Transfusion
• In the first 15 minute the Blood flow rate is limited to 50ml,
except when treating massive trauma.
• Use 40 micro meter Size filter for BT.
• Two Health care professionals ( One the Administering nurse )
verify the Patient's ABO and Rh Blood type and It's compatibility.
• Blood store at 4℃ and Administer on room temperature ( 22 -
23℃ ).Start Transfusion of Blood within 30 minutes after coming
out from blood bank.
• Never use any Solution or Drug except normal Saline during
Blood Transfusion.
• Change BT set in 4 - 6 hours.
• Rapid Transfuse of cold blood may cause Cardiac
Arrhythmias.
• Assess Patient every 15 minute to observe Blood
Transfusion reaction.
• Use 18 gauge needles for Blood Transfusion
Blood Bank
• A Place in which whole Blood and certain
components are Processed and stored until needed for
Transfusion.
• Blood is mixed with Citrate Phosphate Dextrose and
Stored at 4℃ ( 39°F ) for maximum of 40 - 45 days.
• Heparin may be Used as a Preservatives.
• Banked Blood should be used as soon as Possible
because the Longer it is stored, the fewer red blood
cells survive in Usable form.
Complications of Blood Transfusion
1. Transfusion Reaction :-
• Allergic and Hemolytic reaction
Sign & Symptoms
• Fever
• Chills
• Itching
• Sweating
• Nausea & Vomiting
• Tachycardia
• Hypotension
• Dyspnea
• Hematuria
Nursing Intervention :-
• Stop Transfusion ★ & Start 0.9% NS Sodium
Chloride
• Inform doctor
• Check Vital Signs at every 5 minutes.
• Administer antihistamine or other emergency
drugs ( Acetaminophen & Diphenhydramine as
Prescribed ).
• Collect first Voided Urine, Blood unit, Tubing and
Filter and send to Lab.
2. Circulatory Overload / Fluid Overload :-
• Infusion of Blood at a rate of too rapid for the
client to tolerate.
Sign & Symptoms :-
• Cough, Dyspnea, Chest pain and Wheezing
• Hypertension
• Tachycardia and Bounding Pulse
• Distended neck vein
Nursing Interventions :-
• Slow the Flow rate at minimum level
• Place the Client in Upright Position with Feer
dependent.
• 3. Septicemia / Bacteremia :-
• Transfusion of Bacterial contaminat Blood
Sign & Symptoms :-
• Rapid onset of Chills and High fever
• Vomiting
• Diarrhoea
• Hypotension and Shock
Nursing intervention :-
• Stop Transfusion
• Notify to the Physician
• Note :- To Prevent Septicemia BT will complete
in 4 hours.
• If septicemia develops in the patient, the
blood transfusion will be stopped, and Will
send the blood bag back to the blood bank.
4. Iron Overload :-
• Delayed Transfusion complications that Occurs
in clients who receive Multiple
• Blood Transfusion such as Client with Anemia
and Thrombocytopenia.
Sign & Symptoms :-
• Vomiting, Diarrhoea, Hypotension and Altered
Hematological values.
• Nursing Intervention :-
• Administer Deferoxamine ( which remove
accumulated iron by Kidney ).
5. Hyperkelemia :-
• If septicemia develops in the patient, the blood transfusion will
be stopped, and Will send the blood bag back to the blood
bank.
• The patient of renal failure should always be given fresh blood.
Sign & Symptoms :-
• Paresthesias
• Weakness
• Abdominal Cramps
• Dysrhythmia
Nursing Intervention :-
• Slow the Transfusion
• Notify to the HCP
• Medical Management :-
• IV Calcium Gluconate
• Sodium Bicarbonate
• Regular Insulin + Hypertonic Dextrose
• Kayexalate ( Sodium Polystyrene Sulfonate )
6. Hypocalcaemia :-
Excess Citrate present in the blood. It starts to be
excreted from the body, by joining with Calcium.
Which is created Hypocalcaemia
Sign & Symptoms :-
• Muscle Spasm ( Tetany Signs - Positive
Chvostek's Sign & Trousseau's Sign )
• Paresthesias
Intervention :-
• Slow Transfusion
• Notify to HCP
7. Disease Transmission :-
• Massive Blood Transfusion Cause Disease
• Ex :- Hepatitis C & Hepatitis B
