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Blood Transfusion Therapy

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by

Cherry Kris Suarez

on 5 September 2013

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Transcript of Blood Transfusion Therapy

BLOOD TRANSFUSION THERAPY
BLOOD TRANSFUSION THERAPY
is the intravenous administration of whole blood or blood component for therapeutic purposes.

Points of Weakness in the Process
BT Request Form
Nursing Responsibilities
Post Procedure
Obtain vital signs and compare with baseline measurements.
To restore intravascular volume
To restore the oxygen-carrying capacity of blood
To improve clotting time
Platelets
Subject: ORDERING BLOOD & BLOOD PRODUCTS AUTHORIZED PHYSICIANS.

Blood and any blood components are to be ordered by specialists, and/or consultants physicians in charge .
Residents can order blood grouping and antibody screening till the decision of administration the blood components .
The exception is on emergency situations, where the residents can request component’s transfusions till further evaluation by the specialist.
The physician stamp and signature must be clearly on the transfusion request the part that states:
Uncrossmatched
Urgently crossmatched
ABO& RH (same patient)
Group O (free of hemolysis)

MEMORANDUM
1. Approximately 70% of errors take place in clinical areas, with the most frequent error being failure of the final patient identification check at the bedside.

Medication should never be injected into an IV line with the blood component transfusing because of the risk of contaminating the blood product with bacteria
For first 15 minutes, run the transfusion slowly—no faster than 5 mL/min.
Physician’s order
Close monitoring for the first 5 to 15 minutes after the blood transfusion is initiated.
"There continue to be shortages of blood, therefore the Blood Bank acknowledges and appreciates the continuous efforts of physicians and nursing staff of the hospital in encouraging patient's relatives/friends to donate blood."
DONOR RECRUITMENT

 


Time and names of persons starting and ending the transfusion.
Names of individuals verifying patient ID.
Unique product identification number.
Product and volume infused .
Immediate response –for example ,no apparent reaction.


Adult- draw blood 2 to 5 ml
Pediatric- draw blood 1 to 3 ml
Epinephrine
Antihistamine
Antibiotic
Antipyretic/Analgesic
Diuretics
Corticosteroids


is a systemic response to the administration of blood product that is either incompatible with the recipient, contains allergens to which the recipient is sensitive or allergic, or is contaminated with bacteria. The reactions can be acute or delayed.


If the transfusion cannot begin immediately,
return product to blood bank
Clotting Factors
Albumin
Whole Blood
Packed RBC
Plasma
3. Medical reason for transfusion
2. A critical stage of the process is that of blood sampling for pretransfusion testing with the potential for misidentification; the blood sample is labeled with another patient's identity.
Do not specify STAT crossmatch unless blood is urgently needed.

 

The term STAT or URGENT should not be misused as any unnecessary hurry will increase the hazards of transfusion.




BLOOD TRANSFUSION
POLICY
The blood transfusion is started slowly and should be completed within 2 to 4 hours.
Baseline vital signs
Consent must be signed prior to infusion.
Standard precautions
Thank you!
BLOOD TRANSFUSION REACTION
Blood Transfusion Reaction
Stop the transfusion immediately.
Notify the physician.
Secure patient's airway.
Prepare emergency medications at bedside.
Verify order for blood transfusion
Name of patient
Medical record number
Serial Number of Blood
Expiration date
Blood Group and compatibility
Explain procedure to patient and family
Verify need for blood warmer/pressure cuff per hospital policy
Assess that client's temperature is normal and document prior to BT
Ensure that IV site is patent with large-gauge cannula
Verify consent
Review history of previous reaction to BT
Assess client's CBC
Check the blood for gas bubbles and any unusual color or cloudiness.
Pre-medicate the patient per doctor’s order 15 to 30 minutes before transfusion.
Blood or blood products must be taken by a registered nurse from the blood bank.
Blood or blood products to be transfused must be checked at patient’s bedside by two registered nurses and a physician before transfusion.
Note that administration time does not exceed 4 hrs because of the increased risk for bacterial proliferation.
Observe the patient carefully for adverse effects. If no adverse effects occur during the first 15 min, increase the flow rate unless the patient is at high risk for circulatory overload.
A standard blood filter must be used. Do not use the IV tubing set.
Prime the blood administration set with
normal saline.

Close observation throughout the procedure for signs and symptoms of transfusion reaction. Have emergency medications readily available at all times.
Monitor vital signs every 15 minutes for the first hour and every 30 minutes thereon until blood transfusion is completed.
Change blood tubing after every 2 units transfused, to decrease chance of bacterial contamination.
Never store blood in un-authorized refrigerators ,such as those on the nursing unit & platelets must be kept at 20-24 C .
Blood out of proper storage for more than 30 mins cannot be reissued
Monitor patient for response to and effectiveness of the procedure.
Document procedure in patient’s medical record, including patient assessment findings and tolerance to procedure:
Dispose of used materials properly.
Observe the patient frequently throughout the transfusion for any signs of adverse reaction, including restlessness, hives, nausea, vomiting, torso or back pain, shortness of breath, flushing, hematuria, fever, or chills.
When present:
The BLOOD BANK is notified of suspected reaction:
Send the required blood samples, blood bag and tubing as soon as possible
Copy of cross match transfusion tag.
Complete copy of filled transfusion reaction form with signature and stamped by the nurse and the attending physician.
Obtain urine specimen as soon as possible and sent for urine analysis.
-Blood Bank
ASSESSMENT
PRE-TRANSFUSION
INITIATION OF BT
MONITORING OF BT
REMEMBER
The 30mins Rule
IMMEDIATE INTERVENTIONS
LABORATORY INVESTIGATIONS
Full transcript