What is the purpose of blood transfusions?
Improve oxygen transport
Volume expansion
Provision of proteins
Provision of coagulation factors
Provision of platelets
RBC's
Indicated fro anemia or acute blood loss
Prepared from whole blood
Usually 250-350 mL unit bag
Infusion time: 2-4 hours
Whole blood
Rarely used
Used to resolve hypovolemic shock resulting from hemorrhage
Contains RBC, plasma, and plasma proteins
Usually 500 mL
Platelets
Used to treat thrombocytopenia & platelet dysfunction
Unit 30-50 mL of platelets
Agitation of bag is used to prevent platelets from sticking to bag
Given over 15-30 minutes
Fresh-Frozen Plasma
Indicated for bleeding cause by deficiency in clotting factors
Liquid portion of whole blood separated from cells & frozen
Unit 200-250 mL
Plasma is rich in clotting factors but has no platelets
must be used within 2 hrs of thawing
Albumin
Indicated for hypovolemic shock or hypoalbuminemia
Prepared from plasma
Available in 5 or 25% solution
Hyperosmolar solution: For someone who needs volume
Cryoprecipitate
Indicated for replacement of clotting factors
Prepared from fresh frozen plasma
10-30 mL bag
Blood warmers
Use only warming devices specifically designed & approved for blood products, not in microwave or warm water
What is the universal recipient?
AB+
What is the universal donor?
O-
How many nurses are needed during a blood transfusion?
Two
What must the nurses do to give a transfusion?
Check pt ID
Check MD order
Check pt venous access site
Check crossmatching procedures have been completed
Check correct pt is receiving correct blood
Stay with pt for first 15 minutes and monitor pt for S&S of transfusion reaction
No solution other than N
After blood is received from blood bank, when should it be administered?
Within 30 minutes
What should VS & lung sounds be taken?
Before transfusion, again after first 15 minutes and every hour
What size needed should be used and why?
18-19 gauge
To maintain flow and prevent damage to RBC
When is a severe allergic reaction most likely to occur?
First 15 minutes
What are the S&S of transfusion reactions?
Chills & diaphoresis
Fever
Muscle aches, back or chest pain
Rashes, hives, itching & swelling
Rapid, thready pulse
Dyspnea, cough, wheezing or rales
Pallor & cyanosis
Apprehension
Tingling & numbness
Headache
Nausea, vomiting, abd cramping & diarrhea
What are the implementations for transfusion reactions?
Stop transfusion
Change IV tubing down to IV site
Keep line open with NS
Notify MD & blood bank
Stay with pt & monitor VS every 5 minutes
Urine specimen
Emergency meds
Return blood & tubing to blood bank