BLOOD TRANSFUSION
INTRODUCTION
DEFINITION-
Blood transfusion is the transfusion of the whole blood or its
components such as blood cells of or plasma from one person to
another person. Blood transfusion involves two procedures :
collection of blood from toner
administration of blood to the recipient
Blood consists of two parts: 45% of WBCs, RBCs and platelets and
55% of plasma
PURPOSES OF BLOOD TRANSFUSION
To restore the blood volume when there is suddenness of blood due to hemorrhage
To raise the hb level in cases of severe anemia
Two treat deficiencies of plasma protein, clotting factors or hemophilic globulin etc
To provide antibiotics to those person who are sick and have lowered immunity
To replace the blood with hemolytic agents with fresh blood
To improve the leukocyte count in blood as in case of agranulocytosis
To combat infection in leukopenia
COMPONENTS OF BLOOD FOR TRANSFUSION
Each unit of blood is tested for evidence for hepatitis B hepatitis
C in human immunodeficiency virus 1 and 2 and syphilis
The blood is then possessed into subcomponents. These are-
Whole blood
Packed cell volume
Fresh frozen plasma
Platelets
Cryoprecipitate
WHOLE BLOOD
Whole blood is separated in blood containing an anticoagulant
preservative solution
One unit of whole blood contains-
450 ml of donor blood
50 ml of anti cogulant preservative solution
Hemoglobin approximately 12 gram per ml and hematocrit 35% to
45%
No Functional platelets
RBCs and WBCs are stored between +2 and +6 degrees centigrade in
a blood bank refrigerator.
Platelets are stored at 22 to 24 degree centigrade
CONT…
Plasma is divided into two components fresh frozen
plasma and Cryoprecipitate
Fresh frozen plasma is stored at -20 degree centigrade and
cryoprecipitate stored at +2 to +8 degrees centigrade
Transmission should be started within 30 minutes of
removal from the refrigerator and completed within four
hours of commencement because changes in the
composition may occur due to red blood cells metabolism
PACKED CELL VOLUME
Add red cells are cells that are spun down and concentrated
One unit of packed red cell is approximately 250 ml and have a
hematocrit of 50 to 70%
They are stored in SAG-M(Saline Adenine Glucose Mannitol)
solution to increase their shelf life to five weeks at 2 to 6
degrees centigrade
Fresh frozen plasma is rich in coagulation factors
It is separated from whole blood and stored at -40 to -50
degrees centigrade with a two year shelf life
It is the first line therapy in the treatment of coagulathic
hemorrhage
CRYOPRECIPITATE
Cryoprecipitate is a supernatent precipitate of fresh frozen
plasma and is rich in factor VIII and fibrinogen
Indicated in low fibrinogen states ( <1g/L) or in cases of
disease and as a source of fibrinogen in disseminated
intravascular coagulation
Pooled units containing 3 to 6g fibrinogen in 200 to 500 ml
raises the fibrinogen level by approximately 1g/L
Must be infused between 6 hours
TABLE SHOWING COMPARISON
RED BLOOD WHITE PLATLETS PLASMA
CELLS BLOOD
CELLS
NORMAL VALUE 4.7-6.1x106 4000-10,000 1.5-4 lakh -
LIFESPAN 120, 80 and 35- 13-20 days 11 days -
50 days
STORAGE 42 days 11-18 days 11 days 1 year
DURATION
STORAGE 4 degree Celcius 2-8 degree 22-24 degree -20,2-8
TEMPERATURE Celcius Celcius degree
Celcius
STORAGE - - Agitator -
INSTRUMENT
TRANSFUSION 2-4 hours 1 hour 15-20 min 3 min-1
TIME hour
I UNIT AND 250ml and CPD 400ml and - 70 ml and 200-250 ml
ANTICOAGULANTS Or CPD-A sodium citrate and-
1 unit of Packed cell volume increases 1g/dl Hb.
1 unit of Packed cell volume increases 2-3% hematocrit.
If transfusion is slow, it causes septicemia
If transfusion is fast, it causes circulatory overload
85-100 ml/hr, 1-2 ml/min and 10-20 drops/min.
BLOOD GROUPING AND CROSS MATCHING
O-A, B and AB
A-A and AB
B- B and AB
AB- AB
Each person has one of the following blood types: A, B, O, AB.
O can be given to anyone but can only receive from O
AB can receive any type but can only be given to AB.
Also, every person’s blood is either Rh-positive or Rh-negative
The blood used in transfusion must be compatible with the patient’s blood
type
Type O blood is called the universal donor
People with type AB blood are called universal recipients
Type with RS positive blood can get Rh positive or Rh negative blood.
People with Rh negative blood should get only Rh negative blood.
TYPES OF BLOOD TRANSFUSION
Allogenic blood transfusion (someone else blood)
Autogenic blood transfusion (own blood)
Exchange blood transfusion
GENERAL INSTRUCTIONS
Regarding-
Selection of donor
Election Command Storage and transportation of the
blood
Administration of blood to the recipient
SELECTION OF DONOR
Donor should be free from diseases such as TB, cancer, genres or any other
transmissible disease
Make sure the donor has not donated the blood within previous 90 days
Physically active, between the age of 18 to 65 years with an average height
and weight
Donor must have normal vital signs
Must not have been pregnant within the last six months
Hb levels must be above 12 grams%
Donors should be disqualified to have history of recent dental
surgery, major surgery, recipient of blood or blood component,
illness etc
Explain the procedure to the donor
Blood should not be collected empty stomach, should not be
dehydrated
Following the donation, donor should be offered sweetened drink
and asked to take rest at least for one to 2 hours to prevent
faintness.
Before leaving the collection center donor must be observed for
any giddiness, color changes.
Check vital signs frequently.
COLLECTION, TRANSPORTATION
AND STORAGE OF BLOOD
Donors blood immediately after it is withdrawn should be placed
in a refrigerator
Stored blood should be inspected daily and before use for
evidence of hemolysis or bacterial contamination.
The transportation of blood in your hospital should be done
within 30 minutes after it is taken from the place of storage
If the blood is kept at room temperature the temperature of blood
will rise above 10 degrees Celsius in 30 minutes
If the blood is not used it should be returned to the refrigerator
within half an hour
When blood is transported to distant place use pre cooled
insulated bags to keep the temperature of blood below 10
degrees Celsius.
Collection of blood from the donor is done in laboratory by
laboratory technician
Donor’s blood is collected in a sterile container containing anti
cogulant solution (ACD).
All the articles used for the collection of blood must be sterile
Each donor unit must be labelled clear, with readable letters i.e.
name, donor no., ABO grouping Rh typing, date of drawing,
date of expiry and result of tests for Hepatitis and syphilis.
ADMINISTRATION OF BLOOD TO THE
RECIPIENT
When sending the recipients blood sample for grouping and cross
matching, it must be clearly labelled with name IP number, bed
number, ward number.
Fresh sample taken within four hours should be used for typing
and cross matching
A request form should accompany with blood sample and form
should include: name, IP number, bed number, ward number,
name of physician, exact amount of blood components required,
diagnosis of the patient, any blood transfusion given earlier, if so,
the group and type of blood administered and any reaction
observed.
It is essential that the physician writes all the orders for typing
cross matching and administration of whole blood or blood
products
Prior to administration of blood, two registered nurse or a
physician under registered nurse should verify all information on
the report of the cross match, unit label, and the patients
identification if there is any discrepancies, the unit should be
returned to the blood bank and with remarks
Pole blood or blood should be transfused through and appropriate
sterile transfusion set containing a filter
Transfusion set should be free from air
Use 18 gauze needle for transfusion
No medications or other additives should be given the same IV
route or should not be mixed with blood
Keep the patient warm and comfortable if necessary
Offer bedpan before starting the procedure and as necessary
Record the amount of blood, type and group, rate of low any
reaction and any medication administered
If IV be infusion is to be given before, after or during the
transfusion always use a normal saline
Prior to translation record vital signs of the patient to provide the
baseline for further observation
Adjust the rate of flow to 5 to 10 ml per minute during the first 30
minutes of transfusion to detect any complications as early as
possible
Allow the blood to remain at room temperature prior to
administration of blood
Watch for any complications throughout the procedure
COMPLICATIONS OF BLOOD TRANSFUSION
DEFINITION
Blood transfusion reaction is a systemic response by the
body to the blood incompatible with that of recipient. It is
mainly caused due to-
ABO incompatibility
Allergic reactions to the WBCs, platelets or plasma
protein components of the transfused blood
Potassium or citrate preservative in the blood
TYPES OF BLOOD TRANSFUSIONS
REACTIONS
Acute haemolytic transfusion reaction
Delayed hemolytic transfusion reaction
Pyrogenic reaction
Allergic reaction
Anaphylactic reaction
Transmission of infectious diseases
COMPLICATIONS OF BLOOD TRANSFUSIONS
Circulatory overload
Hyperkalemia
Hypocalcemia(most common)
Haemosederosis
Infilteration and hematoma
Thrombophlebitis
Pulmonary embolism
CONCLUSION
A blood transfusion is a safe procedure that replaces blood
lost to injury or surgery. It can also help treat certain medical
conditions. Blood transfusions can be lifesaving, but they can
cause some mild side effects. Although infections are very
rare, it is possible for the body to react to the new blood.
A blood transfusion is a common medical procedure wherein
a patient receives blood (which can be from a donor or blood
bank) through an intravenous (IV) line. This becomes
necessary in case of severe blood loss which can be due to an
injury, illness, or surgical procedure.
The most important aspect about transfusions is making sure the
blood used is compatible with the patient’s blood type; otherwise,
complications may occur. This procedure is not without risks, so
a strict and proper process has to be followed when a transfusion
is necessary, and patients undergoing it are placed under close
monitoring in case complications arise.
You might need further blood testing to see how your body is
responding to the donor blood and to check your blood counts.
Some conditions require more than one blood transfusion.
BIBLIOGRAPHY
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