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BLOOD
TRANSFUSION
   Laud, Katherine L.
      BSN – 3A
At the end of 30 minutes, the group should
be able to:
• Define Blood Transfusion
• Identify purposes of the procedure
• Cite situations in which blood transfusion is
  needed
• Enumerate the different transfusion reactions
  with its clinical signs and appropriate nursing
  interventions
• Classify and describe the different blood
  products and how it is being used
BLOOD TRANSFUSION


• It is a procedure in which a patient
  receives a blood product through an
  intravenous line.
• It is the introduction of blood components
  into the venous circulation.
• Process of transferring blood-based
  products from one person into the
  circulatory system of another.
Purposes

• To replace blood lost during surgery or a serious
  injury.
• To restore oxygen-carrying capacity of the blood.
• To provide plasma factors to prevent or treat
  bleeding.
• Done if patient’s body is not capable of making
  blood properly because of an illness.
Typical Situations in which blood
          products are given
• Major injuries after an accident or
  disaster
• Surgery on an organ such as the liver
  and the heart
• Severe Anemia
• Bleeding such as Haemophilia and
  Thrombocytopenia
BLOOD TYPES




Blood Types and their Compatibility
BLOOD TYPES

•Each person has one of the following blood
            types: A, B, AB, or O.
  •O can be given to anyone but can only
                  receive 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.
BLOOD TYPES

    • The blood used in a 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
  • People with Rh-positive blood can get Rh-
  positive or Rh-negative blood. But people with
      Rh-negative blood should get only Rh-
                 negative blood.
BLOOD BANKS


• Blood banks collect, test, and store
  blood.
• Autologous transfusion - If surgery
  is scheduled months in advance,
  patients may be able to donate their
  own blood and have it stored.
PREPARATION


• Before a blood transfusion, a
  technician tests the patient's blood to
  find out what blood type they have
  (that is, A, B, AB, or O and Rh
  positive or Rh negative).
• Some patients may have allergic
  reactions even when the blood given
  does work with their own blood type.
ADMINISTERING BLOOD


• Blood transfusions take place
  in either a doctor's office or a
  hospital. They can be done at
  the patient's home, but this is
  less common.
ADMINISTERING BLOOD


• A needle is used to insert an intravenous
  (IV) line into a blood vessel. Through this
  line, the blood is transfused. The
  procedure usually takes one to four hours.
  The time depends on how much blood is
  needed, which blood product is given, and
  whether the patient's body can safely
  receive blood quickly or not.
ADMINISTERING BLOOD


• During the blood transfusion, a
  nurse carefully watches the
  patient, especially for the first
  15 minutes. This is when bad
  reactions are most likely to
  occur.
ADMINISTERING BLOOD


• After a blood transfusion,
  vital signs are checked
  (such as temperature, blood
  pressure, respiration rate,
  and heart rate).
ADMINISTERING BLOOD


• Follow-up blood
  tests may be necessary
  to show how the body is
  reacting to the
  transfusion.
TRANSFUSION REACTIONS

                                                                 NURSING
 REACTION:CAUSE                CLINICAL SIGNS
                                                             INTERVENTIONS
Hemolytic Reaction:          Chills, fever, headache, 1. Discontinue the
incompatibility between      backache, dyspnea,          transfusion immediately.
client’s blood and donor’s   cyanosis, chest pain,       NOTE: when the
                                                         transfusion is
blood                        tachycardia, hypotension    discontinued, use new
                                                             tubing for the normal
                                                             saline infusion.
                                                        2.   Notify primary care
                                                             provider immediately.
                                                        3.   Monitor vital signs.
                                                        4.   Monitor fluid intake and
                                                             output.
                                                        5.   Send the remaining
                                                             blood, bag, filter, tubing,
                                                             a sample of the client’s
                                                             blood, and a urine
                                                             sample to the laboratory.
TRANSFUSION REACTIONS

                                                             NURSING
 REACTION:CAUSE              CLINICAL SIGNS
                                                        INTERVENTIONS
Febrile Reaction:           Fever, chills, warm and   1. Discontinue the
sensitivity of the client’s flushed skin, headache,      transfusion
blood to white blood        anxiety, muscle pain         immediately.
cells, platelets, or plasma                           2. Give antipyretics as
proteins                                                 ordered.
                                                      3. Notify the primary
                                                         care provider.
                                                      4. Keep the vein open
                                                         with a normal saline
                                                         infusion.
TRANSFUSION REACTIONS

                                                         NURSING
 REACTION:CAUSE              CLINICAL SIGNS
                                                     INTERVENTIONS
Allergic Reaction (Mild) Flushing, itching,       1. Stop or slow the
                         urticaria, bronchial        transfusion, depending
                         wheezing                    on agency protocol.
                                                  2. Notify the primary care
                                                     provider.
                                                  3. Administer
                                                     antihistamines as
                                                     ordered.
Allergic Reaction         Dyspnea, chest pain,    1. Stop the transfusion.
(Severe)                  circulatory collapse,   2. Keep the vein open with
                          cardiac arrest             a normal saline solution.
                                                  3. Notify the primary care
                                                     provider immediately.
                                                  4. Monitor vital signs.
                                                     Administer CPR if
                                                     needed.
                                                  5. Administer medications
                                                     or oxygen as ordered.
TRANSFUSION REACTIONS

                                                      NURSING
 REACTION:CAUSE           CLINICAL SIGNS
                                                  INTERVENTIONS
Circulatory Overload:   Cough, dyspnea,         1. Place the client
blood administered      crackles (rales),          upright, with feet
faster than the         distended neck veins,      dependent.
circulation can         tachycardia,            2. Stop or slow the
accommodate             hypertension               transfusion.
                                                3. Notify the primary
                                                   care provider.
                                                4. Administer diuretics
                                                   or oxygen as
                                                   ordered.
TRANSFUSION REACTIONS

                                                    NURSING
 REACTION:CAUSE          CLINICAL SIGNS
                                               INTERVENTIONS
Sepsis: contaminated   High fever, chills,   1. Stop the transfusion.
blood administered     vomiting, diarrhea,   2. Keep the vein open
                       hypotension              with a normal saline
                                                solution infusion.
                                             3. Notify the primary
                                                care provider.
                                             4. Administer IV fluids,
                                                Antibiotics.
                                             5. Obtain a blood
                                                specimen from the
                                                client for culture.
                                             6. Send the remaining
                                                blood and tubing to
                                                the laboratory
BLOOD PRODUCTS


• Components of the blood which
  are collected from a donor for use
  in blood transfusion.
BLOOD PRODUCTS

       PRODUCTS                   DESCRIPTION
                             Most common type of
                              blood product for
                              transfusion
                             Used to increase the
                              oxygen-carrying capacity
A. Packed Red Blood Cells
                              of blood
   (PRBCs)
                             Help the body get rid of
                              carbon dioxide and other
                              waste products
                             1 unit of PRBCs = raises
                              hematocrit by 2-3%
BLOOD PRODUCTS

       PRODUCTS                 DESCRIPTION
                          Plasma is the liquid
                           component of blood; it has
                           proteins called clotting
                           factors
                          Expands blood volume
B. Fresh Frozen Plasma
                           and provides clotting
   (FFP)
                           factors
                          Contains no RBCs
                          1 unit of FFP = increases
                           level of any clotting factor
                           by 2-3%
BLOOD PRODUCTS
        PRODUCTS             DESCRIPTION
                       Also known as
                        thrombocytes
                       Tiny cell structures
                        necessary in blood clotting
                        process
                       Replaces platelets in
C. Platelets            clients with bleeding
                        disorders, or platelet
                        deficiency
                       1 unit = increases the
                        average adult client’s
                        platelet count by about
                        5,000 platelets/microliter
BLOOD PRODUCTS

       PRODUCTS                 DESCRIPTION
                           Not commonly used
                            except for extreme cases
D. Whole Blood              of acute hemorrhage
                           Replaces blood volume
                            and all blood products
                           Used for blood
                            replacement following
E. Autologous Red Blood
                            planned elective surgery
   Cells
                           Must be donated 4-5
                            weeks prior to surgery
BLOOD PRODUCTS

        PRODUCTS                 DESCRIPTION
F. Albumin and Plasma      Blood volume expander
   Protein Fraction        Provides plasma protein
                           A portion of plasma
                            containing certain specific
G. Clotting Factors and     clotting factors
  Cryoprecipitate          Used for clients with
                            clotting factor deficiencies
                           Contains Fibrinogen
REFERENCE:

• Kozier, et al. Fundamentals of Nursing Concepts,
  Process, and Practice. Ed 8. Vol 2

• http://wiki.medpedia.com/Blood_Transfusion - August 2,
  2010



                     THANK YOU^^

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Wardclass powerpoint blood transfusion

  • 1. BLOOD TRANSFUSION Laud, Katherine L. BSN – 3A
  • 2. At the end of 30 minutes, the group should be able to: • Define Blood Transfusion • Identify purposes of the procedure • Cite situations in which blood transfusion is needed • Enumerate the different transfusion reactions with its clinical signs and appropriate nursing interventions • Classify and describe the different blood products and how it is being used
  • 3. BLOOD TRANSFUSION • It is a procedure in which a patient receives a blood product through an intravenous line. • It is the introduction of blood components into the venous circulation. • Process of transferring blood-based products from one person into the circulatory system of another.
  • 4. Purposes • To replace blood lost during surgery or a serious injury. • To restore oxygen-carrying capacity of the blood. • To provide plasma factors to prevent or treat bleeding. • Done if patient’s body is not capable of making blood properly because of an illness.
  • 5. Typical Situations in which blood products are given • Major injuries after an accident or disaster • Surgery on an organ such as the liver and the heart • Severe Anemia • Bleeding such as Haemophilia and Thrombocytopenia
  • 6. BLOOD TYPES Blood Types and their Compatibility
  • 7. BLOOD TYPES •Each person has one of the following blood types: A, B, AB, or O. •O can be given to anyone but can only receive 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.
  • 8. BLOOD TYPES • The blood used in a 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 • People with Rh-positive blood can get Rh- positive or Rh-negative blood. But people with Rh-negative blood should get only Rh- negative blood.
  • 9. BLOOD BANKS • Blood banks collect, test, and store blood. • Autologous transfusion - If surgery is scheduled months in advance, patients may be able to donate their own blood and have it stored.
  • 10. PREPARATION • Before a blood transfusion, a technician tests the patient's blood to find out what blood type they have (that is, A, B, AB, or O and Rh positive or Rh negative). • Some patients may have allergic reactions even when the blood given does work with their own blood type.
  • 11. ADMINISTERING BLOOD • Blood transfusions take place in either a doctor's office or a hospital. They can be done at the patient's home, but this is less common.
  • 12. ADMINISTERING BLOOD • A needle is used to insert an intravenous (IV) line into a blood vessel. Through this line, the blood is transfused. The procedure usually takes one to four hours. The time depends on how much blood is needed, which blood product is given, and whether the patient's body can safely receive blood quickly or not.
  • 13. ADMINISTERING BLOOD • During the blood transfusion, a nurse carefully watches the patient, especially for the first 15 minutes. This is when bad reactions are most likely to occur.
  • 14. ADMINISTERING BLOOD • After a blood transfusion, vital signs are checked (such as temperature, blood pressure, respiration rate, and heart rate).
  • 15. ADMINISTERING BLOOD • Follow-up blood tests may be necessary to show how the body is reacting to the transfusion.
  • 16. TRANSFUSION REACTIONS NURSING REACTION:CAUSE CLINICAL SIGNS INTERVENTIONS Hemolytic Reaction: Chills, fever, headache, 1. Discontinue the incompatibility between backache, dyspnea, transfusion immediately. client’s blood and donor’s cyanosis, chest pain, NOTE: when the transfusion is blood tachycardia, hypotension discontinued, use new tubing for the normal saline infusion. 2. Notify primary care provider immediately. 3. Monitor vital signs. 4. Monitor fluid intake and output. 5. Send the remaining blood, bag, filter, tubing, a sample of the client’s blood, and a urine sample to the laboratory.
  • 17. TRANSFUSION REACTIONS NURSING REACTION:CAUSE CLINICAL SIGNS INTERVENTIONS Febrile Reaction: Fever, chills, warm and 1. Discontinue the sensitivity of the client’s flushed skin, headache, transfusion blood to white blood anxiety, muscle pain immediately. cells, platelets, or plasma 2. Give antipyretics as proteins ordered. 3. Notify the primary care provider. 4. Keep the vein open with a normal saline infusion.
  • 18. TRANSFUSION REACTIONS NURSING REACTION:CAUSE CLINICAL SIGNS INTERVENTIONS Allergic Reaction (Mild) Flushing, itching, 1. Stop or slow the urticaria, bronchial transfusion, depending wheezing on agency protocol. 2. Notify the primary care provider. 3. Administer antihistamines as ordered. Allergic Reaction Dyspnea, chest pain, 1. Stop the transfusion. (Severe) circulatory collapse, 2. Keep the vein open with cardiac arrest a normal saline solution. 3. Notify the primary care provider immediately. 4. Monitor vital signs. Administer CPR if needed. 5. Administer medications or oxygen as ordered.
  • 19. TRANSFUSION REACTIONS NURSING REACTION:CAUSE CLINICAL SIGNS INTERVENTIONS Circulatory Overload: Cough, dyspnea, 1. Place the client blood administered crackles (rales), upright, with feet faster than the distended neck veins, dependent. circulation can tachycardia, 2. Stop or slow the accommodate hypertension transfusion. 3. Notify the primary care provider. 4. Administer diuretics or oxygen as ordered.
  • 20. TRANSFUSION REACTIONS NURSING REACTION:CAUSE CLINICAL SIGNS INTERVENTIONS Sepsis: contaminated High fever, chills, 1. Stop the transfusion. blood administered vomiting, diarrhea, 2. Keep the vein open hypotension with a normal saline solution infusion. 3. Notify the primary care provider. 4. Administer IV fluids, Antibiotics. 5. Obtain a blood specimen from the client for culture. 6. Send the remaining blood and tubing to the laboratory
  • 21. BLOOD PRODUCTS • Components of the blood which are collected from a donor for use in blood transfusion.
  • 22. BLOOD PRODUCTS PRODUCTS DESCRIPTION  Most common type of blood product for transfusion  Used to increase the oxygen-carrying capacity A. Packed Red Blood Cells of blood (PRBCs)  Help the body get rid of carbon dioxide and other waste products  1 unit of PRBCs = raises hematocrit by 2-3%
  • 23. BLOOD PRODUCTS PRODUCTS DESCRIPTION  Plasma is the liquid component of blood; it has proteins called clotting factors  Expands blood volume B. Fresh Frozen Plasma and provides clotting (FFP) factors  Contains no RBCs  1 unit of FFP = increases level of any clotting factor by 2-3%
  • 24. BLOOD PRODUCTS PRODUCTS DESCRIPTION  Also known as thrombocytes  Tiny cell structures necessary in blood clotting process  Replaces platelets in C. Platelets clients with bleeding disorders, or platelet deficiency  1 unit = increases the average adult client’s platelet count by about 5,000 platelets/microliter
  • 25. BLOOD PRODUCTS PRODUCTS DESCRIPTION  Not commonly used except for extreme cases D. Whole Blood of acute hemorrhage  Replaces blood volume and all blood products  Used for blood replacement following E. Autologous Red Blood planned elective surgery Cells  Must be donated 4-5 weeks prior to surgery
  • 26. BLOOD PRODUCTS PRODUCTS DESCRIPTION F. Albumin and Plasma  Blood volume expander Protein Fraction  Provides plasma protein  A portion of plasma containing certain specific G. Clotting Factors and clotting factors Cryoprecipitate  Used for clients with clotting factor deficiencies  Contains Fibrinogen
  • 27. REFERENCE: • Kozier, et al. Fundamentals of Nursing Concepts, Process, and Practice. Ed 8. Vol 2 • http://wiki.medpedia.com/Blood_Transfusion - August 2, 2010 THANK YOU^^