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Blood transfusion

it is a advanced procedure coming under fundamentals of nursing,1st year bscnursing

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Blood transfusion

  1. 1. Blood transfusion Prepared by : Christian Raveina
  2. 2. Definition •Blood transfusion is the IV administration of whole blood or its component such as plasma , packed red blood cells or platelets to a patient
  3. 3. Purposes •To increasing circulating blood volume •To increase the no. of red blood cells & to maintain hemoglobin level •To provide plasma clotting factors, to help in controlling bleeding •To combat infection due to decreased or defective white cells or antibodies
  4. 4. Indications • After surgery , trauma or hemorrhage • Severe anemia • Leukopenia(↓se WBC) • Agranulocytosis (bonemarrow does not produce enough or mature WBC)
  5. 5. Blood groups & their respective agents •Group : AB A B O •The group O is universal “donor” •The group AB is universal “recipient “
  6. 6. Pre-transfusion assessment • Patient history of previous transfusion , reactions to transfusions , No. of pregnancies a women has , health problem , cardiac , pulmonary & vascular diseases • Physical assessment – baseline vital signs , auscultation of lungs & patients use of accessory muscles , edema , jugular vein distention , skin rashes , petechial , echymosis , icterus etc • Patients teaching : patient should be taught about the sign & symptoms of adverse reactions
  7. 7. Selection of donor •Should not be suffering from any illness •Should not have donated blood within previous 3 months •Should be healthy & in the age group of 18-65 years •Should not be pregnant •Should have Hb level above 12 gm % •Should have normal vital signs
  8. 8. Preparation of recipient •Explain the procedure to the patient & relatives •Ask whether he/she has undergone prior transfusion & reactions •Take informed consent from the patient/relative •Provide comfortable position to the patient
  9. 9. •Check & record the vital signs of the patient •Offer a bedpan before starting the procedure •Educate the patient about adverse reactions & ask her/him to report immediately
  10. 10. Preparation of articles •A tray containing : •A blood transfusion set , a mackintosh & a towel •A tourniquet , cotton swabs with antiseptic •Adhesive tape & scissors , gloves , kidney tray •IV stand ,NS, paper bag , Blood or any of its components with cover received from blood bank with the name of recipient
  11. 11. Procedure
  12. 12. • Wash hands , wear gloves • Perform vein puncture by selecting a large vein which allows the patients mobility • Check the blood to be transfused for group , Rh type , expiry date etc. Also inspect for abnormal colour , cloudiness , clot & excess air • Open the packing of blood transfusion set aseptically & insert infusion set into
  13. 13. •Check the needle & solution of previous IV infusion whether they are appropriate for administering blood. The needle no.18 or 19 & solution must be NS •Put pressure by placing tourniquet 10-12 cm above insertion site & ask patient to clench fist •Clean the insertion site with iodine & spirit •Insert the needle & start infusion with NS
  14. 14. • Firstly identify blood product & patient thoroughly & the transfusion is begun • For first 15 min adjust flow at 2ml/min & remain with patient . If any reaction is suspected , notify the physician • Monitor vital signs every 5 min for first 15 min • Observe for flushing , itching , dyspnea , rash or any other adverse reaction
  15. 15. •Then infusion rate should be set as per physician’s order •Remove & dispose of gloves, wash hands •Record with date , time , blood group , adverse reactions & amount of blood infused • 1 unit of blood contains 350ml of blood • Preservative – citrate dextrose phosphate adenine
  16. 16. Complications of BT
  17. 17. • Hemolytic transfusion reaction : • Occurs due to incompatibility of blood, incomplete storage of blood , storage beyond 21 days , warming of blood above 40◦C or by exposure of red cells to dextrose solutions It is indicated by fever , chills , head-ache , dyspnea , cyanosis , chest pain etc. There may be a drop in B.P. , oliguria or may cause anuria • Pyrogenic reactions : • Its incidence gets decreased now a days due to use of disposable sets .It occurs when there are some external substances present in the tubings , characterized by fever with chills , nausea , vomiting , diarrhea , headache , backache , delirium , shock & renal failure
  18. 18. •Allergic reactions : • There are due to individual sensitivity to plasma proteins characterized by itching , laryngeal edema & bronchial spasms •Circulatory overloads : • It occurs in people suffering from severe anemia , as they need only RBC’s , but when they receive the whole blood . Patients with heart failure are more vulnerable for circulatory overload
  19. 19. •Transmission of infectious diseases : • Various diseases like hepatitis, AIDS , malaria , syphilis etc. are transmitted through blood when not properly checked •Anaphylactic reactions : • These occur rarely but are life threatening condition characterized by a severe respiratory & cardio-vascular collapse , severe GI disturbances
  20. 20. Nursing responsibilities • Nurse is responsible for safety & effectively administering IV infusion • Nurse must have legal knowledge about infusion • Nurse should do through assessment of patients • Physical condition , medical history , allergies & dietary pattern should be known by nurse
  21. 21. • Nurse should have knowledge about calculation of flow rate & methodical approach • Nurse should apply physiological , anatomical & aseptic principles • Nurse should have vigilant observation throughout the procedure so as to prevent adverse reactions which can sometimes be fatal
  22. 22. Thank you … 