2. www.palnurse.com
What Is a Blood
Blood is composed of fluid and
different kinds of blood cells.
Plasma is the fluid portion of blood.
White Blood Cells protect against disease and
infection. It range 4.5 – 11 k/ul
Platelets help form blood clots when bleeding occurs.
It range 150 – 450 k/ul .
Red Blood Cells transport oxygen from the lungs to the
other cells of the body and return carbon dioxide to the
lungs. It range 4 – 5.5 k/ul
3. www.palnurse.com
What Is a Blood Transfusion
A blood transfusion is a safe, common procedure in
which blood is given to you through an intravenous
(IV) line in one of your blood vessels. Blood
transfusions are done to replace blood lost during
surgery or a serious injury. A transfusion also may be
done if your body can't make blood properly because
of an illness.
During a blood transfusion, a small needle is used to
insert an IV line into one of your blood vessels.
Through this line, you receive healthy blood. The
procedure usually takes 1 to 4 hours, depending on
how much blood you need.
4. www.palnurse.com
Important Information About Blood
The heart pumps blood through a network of
arteries and veins throughout the body. Blood has
many vital jobs. It carries oxygen and other
nutrients to your body's organs and tissues. Having
a healthy supply of blood is important to your
overall health.
Blood is made up of various parts, including red
blood cells, white blood cells, platelets, and plasma.
Blood is transfused either as whole blood (with all
its parts) or, more often, as individual parts.
5. www.palnurse.com
Blood Types
Every person has one of the following blood types:
A, B, AB, or O. Also, every person's blood is either
Rh-positive or Rh-negative. So, if you have type A
blood, it's either A positive or A negative.
The blood used in a transfusion must work with
your blood type. If it doesn't, antibodies (proteins)
in your blood attack the new blood and make you
sick.
6. www.palnurse.com
Blood Types
Type O blood is safe for almost everyone. About 40
percent the population has type O blood. People with
this blood type are called universal donors. Type O
blood is used for emergencies when there's no time
to test a person's blood type.
People with type AB blood are called universal
recipients. This means they can get any type of
blood.
7. www.palnurse.com
Blood Types
If you have Rh-positive blood, you can get Rh-
positive or Rh-negative blood. But if you have Rh-
negative blood, you should get only Rh-negative
blood.
Rh-negative blood is used for emergencies when
there's no time to test a person's Rh type.
8.
9. www.palnurse.com
Blood Banks
Blood banks collect, test, and store blood. They carefully
screen all donated blood for possible infectious agents,
such as viruses that could make you sick.
Blood bank staff also screen each blood donation to find
out whether it's A, B, AB, or O and whether it's Rh-
positive or Rh-negative. Getting a blood type that doesn't
work with your own blood type will make you very sick.
That's why blood banks are very careful when they test
the blood.
10. www.palnurse.com
Blood Banks
To prepare blood for a transfusion, some blood
banks remove white blood cells. This process is
called white cell or leukocyte reduction. Although
rare, some people are allergic to white blood cells
in donated blood. Removing these cells makes
allergic reactions less likely.
11. www.palnurse.com
Blood Banks
Not all transfusions use blood donated from a
stranger. If you're going to have surgery, you may
need a blood transfusion because of blood loss
during the operation. If it's surgery that you're able
to schedule months in advance, your doctor may
ask whether you would like to use your own
blood, rather than donated blood.
12. www.palnurse.com
Blood Banks
If you choose to use your own blood, you will
need to have blood drawn a few times prior to the
surgery. A blood bank will store your blood for
your use.
13. www.palnurse.com
Types of Blood Transfusions
Blood is transfused either as whole blood (with all
its parts) or, more often, as individual parts. The
type of blood transfusion you need depends on
your situation.
For example, if you have an illness that stops your
body from properly making a part of your blood,
you may need only that part to treat the illness.
14. www.palnurse.com
Red Blood Cell Transfusions
Red blood cells are the most commonly transfused
part of the blood. These cells carry oxygen from
the lungs to your body's organs and tissues. They
also help your body get rid of carbon dioxide and
other waste products. You may need a transfusion
of red blood cells if you've lost blood due to an
injury or surgery.
15. www.palnurse.com
Red Blood Cell Transfusions
You may need this type of transfusion if you have
severe anemia due to disease or blood loss. Anemia is
a condition in which your blood has a lower than
normal number of red blood cells, or the red blood
cells don't have enough hemoglobin . Hemoglobin—
an iron-rich protein that gives blood its red color—
carries oxygen from the lungs to the rest of the body.
16. www.palnurse.com
Platelets and Clotting Factor
Transfusions
Platelets and clotting factors help stop bleeding,
including internal bleeding that you can't see.
Some illnesses may cause your body to not make
enough platelets or other clotting factors. You may
need regular transfusions of these parts of your
blood to stay healthy.
17. www.palnurse.com
Platelets and Clotting Factor
Transfusions
For example, if you have hemophilia A, you may need a special
clotting factor to replace the clotting factor you're lacking.
Hemophilia is a rare, inherited bleeding disorder in which your
blood doesn't clot normally.
If you have hemophilia, you may bleed for a longer time than
others after an injury or accident. You also may bleed internally,
especially in the joints (knees, ankles, and elbows).
18. www.palnurse.com
Plasma Transfusions
Plasma is the liquid part of your blood. It's mainly
water, but also contains proteins, clotting factors,
hormones, vitamins, cholesterol, sugar, sodium,
potassium, calcium, and more.
If you have been badly burned or have liver failure or
a severe infection, you may need a plasma
transfusion.
19. www.palnurse.com
Who Needs a Blood Transfusion
Many people who have surgery need blood
transfusions because they lose blood during the
operation. For example, about one-third of all heart
surgery patients have a transfusion.
Some people who have serious injuries—such as
from car wrecks, war, or natural disasters—need
blood transfusions to replace blood lost during the
injury.
20. www.palnurse.com
Who Needs a Blood Transfusion
Some people need blood or parts of the
blood because of illnesses. You may need a
blood transfusion if you have:
A severe infection or liver disease that stops
your body from properly making blood or
some parts of blood.
21. www.palnurse.com
Who Needs a Blood Transfusion
An illness that causes anemia, such as kidney
disease or cancer. Medicines or radiation used to
treat a medical condition also can cause anemia.
There are many different types of anemia, including
aplastic, Fanconi, hemolytic, iron-deficiency, and
sickle cell anemias and thalassemia.
A bleeding disorder, such as hemophilia or
thrombocytopenia.
22. www.palnurse.com
Before a Blood Transfusion
Before a blood transfusion, a technician tests your
blood to find out what blood type you have (that is,
A, B, AB, or O and Rh positive or Rh negative). He
or she pricks the client finger with a needle to get a
few drops of blood or draws blood from one of
your veins.
The blood type used in client transfusion must
work with client blood type. If it doesn't, antibodies
(proteins) in your blood attack the new blood and
make you sick.
23. www.palnurse.com
Before a Blood Transfusion
Some patients have allergic reactions even when the blood
given does work with their own blood type. To prevent this,
your doctor may prescribe a medicine to stop allergic
reactions.
Client have allergies or have had an allergic reaction during a
past transfusion, your doctor will make every effort to make
sure you're safe.
Most patients don't need to change their diet or activities
before or after a blood transfusion. Your doctor will let you
know whether you need to make any lifestyle changes prior to
the procedure.
24. www.palnurse.com
Before a Blood Transfusion
The nurse should being sure of :
The doctor order and signature.
The serial number of blood unit.
The blood type of ordered unit and pt’s blood type.
Date of having blood unit not exceed one month.
25.
26. www.palnurse.com
During a Blood Transfusion
A needle is used to insert an intravenous (IV) line into
one of your blood vessels. Through this line, you
receive healthy blood. The procedure usually takes 1 to
4 hours. The time depends on how much blood you
need and what part of the blood you receive.
27. www.palnurse.com
During a Blood Transfusion
During the blood transfusion, a nurse carefully
watches you, especially for the first 15 minutes.
This is when reactions are most likely to occur.
The nurse continues to watch you during the rest of
the procedure as well.
28. www.palnurse.com
During a Blood Transfusion
The nurse should :
Assessment of vital signs prior to transfusion
Tow nurses verify correct client and unit of blood
are correctly matched
Direct observation of client during first 15 minutes
of infusion
Check vital signs according to protocol
29. www.palnurse.com
During a Blood Transfusion
If Blood transfusion reaction occur the nurse should:
Stop transfusion immediately
Continue IV infusion with normal saline
Notify physician of client’s signs and symptoms
Provide care for client as indicated
Complete reaction form according to institution protocol.
Obtain urine specimen from client and send for free
hemoglobin.
30. www.palnurse.com
After a Blood Transfusion
After a blood transfusion, your vital signs are
checked (such as your temperature, blood pressure,
and heart rate). The intravenous line (IV) is taken out.
Client may have some bruising or soreness for a few
days at the site where the IV was inserted.
Client may need blood tests that show how your body
is reacting to the transfusion.
You will let the client know about signs and
symptoms to watch for and report.
31. www.palnurse.com
Risks of a Blood Transfusion
Allergic Reaction
Some people have allergic reactions to the blood
given during transfusions. This can happen even
when the blood given is the right blood type.
Allergic reactions can be mild or severe.
Symptoms can include:
Anxiety
Chest and/or back pain
Trouble breathing
32. www.palnurse.com
Risks of a Blood Transfusion
Fever, chills, flushing, and clammy skin
A high pulse or low blood pressure
Nausea (feeling sick to the stomach)
A transfusion is stopped at the first signs of an allergic
reaction. The health care team determines how mild or
severe the reaction is, what treatments are needed, and
if the transfusion can safely be restarted.
33. www.palnurse.com
Risks of a Blood Transfusion
Viruses and Infectious Diseases
Some infectious agents, such as HIV, can survive in blood and
infect the person receiving the blood transfusion. To keep blood
safe, blood banks carefully screen donated blood.
There is a risk of catching a virus from a blood transfusion, but
it's very low.
HIV. Your risk of getting HIV from a blood transfusion is lower
than your risk of getting killed by lightning. Only about 1 in 2
million donations may carry HIV and transmit HIV if given to a
patient.
Hepatitis B and C. The risk of having a donation that carries
hepatitis B is about 1 in 205,000. The risk for hepatitis C is 1 in
2 million. If you receive blood during a transfusion that contains
hepatitis, you will likely develop the virus.
34. www.palnurse.com
Risks of a Blood Transfusion
Fever
Client may get a sudden fever during or within a day of your
blood transfusion. This is usually your body's normal response
to white blood cells in the donated blood. Over-the-counter
fever medicine will usually treat the fever.
Some blood banks remove white blood cells from whole blood
or different parts of the blood. This makes it less likely that
you will have a reaction after the transfusion.
35. www.palnurse.com
Risks of a Blood Transfusion
Iron Overload
Getting many blood transfusions can cause too much iron
to build up in your blood (iron overload). People with a
blood disorder like thalascemia, which requires multiple
transfusions, are at risk of iron overload. Iron overload
can damage your liver, heart, and other parts of your
body.
If you have iron overload, you may need iron chelation
therapy. For this therapy, medicine is given through an
injection or as a pill to remove the extra iron from your
body
36. www.palnurse.com
Risks of a Blood Transfusion
Lung Injury
Although it's unlikely, blood transfusions can damage your lungs,
making it difficult to breathe. This usually occurs within about 6
hours of the procedure. Most patients recover. However, 5 to 25
percent of patients who develop lung injuries die from the injury.
These people usually were very ill before the transfusion.
Researchers aren't completely sure why blood transfusions
damage the lungs. Antibodies (proteins)—which are more likely
to be found in the plasma of women who have been pregnant—
may disrupt the normal way that lung cells work. Because of this
risk, hospitals are starting to use men and women's plasma
differently.
37.
38. www.palnurse.com
Risks of a Blood Transfusion
Acute Immune Hemolytic Reaction
Acute immune hemolytic reaction is very serious, but
also very rare. It occurs if the blood type you get
during a transfusion doesn't match or work with your
blood type. Your body attacks the new red blood
cells, which then produce substances that harm your
kidneys.
The symptoms include chills, fever, nausea, pain in
the chest or back, and dark urine. The doctor will stop
the transfusion at the first sign of this reaction.
39. www.palnurse.com
Risks of a Blood Transfusion
Delayed Hemolytic Reaction
This is a much slower version of acute immune
hemolytic reaction. Your body destroys red blood
cells so slowly that the problem can go unnoticed
until your red blood cell level is very low.
Both the acute and delayed hemolytic reactions are
most common in patients who have had a previous
transfusion.
40. www.palnurse.com
Risks of a Blood Transfusion
Graft-Versus-Host Disease
Graft-versus-host disease (GVHD) is when white blood
cells in the new blood attack your tissues. GVHD is usually
fatal. People who have weakened immune systems are the
most likely to get GVHD.
Symptoms start within a month of the blood transfusion.
They include fever, rash, and diarrhea. To protect against
GVHD, patients with weakened immune systems should
receive blood that has been treated so the white blood cells
can't cause GVHD
41. www.palnurse.com
Alternatives to Blood Transfusions
Researchers are trying to find ways to make blood. There
is currently no man-made alternative to human blood.
However, researchers have developed medicines that may
help do the job of some blood parts.
For example, some patients with kidney problems can now
take a medicine called erythropoietin that helps their
bodies make more red blood cells. This means they may
need fewer blood transfusions.
Surgeons try to reduce the amount of blood lost during
surgery so that fewer patients need blood transfusions.
Sometimes they can collect and reuse the blood for the
patient.
42. www.palnurse.com
Key Points
A blood transfusion is a safe procedure in which blood is
given to you through an intravenous (IV) line in one of your
blood vessels.
Blood is transfused either as whole blood (with all its parts)
or, more often, as individual parts. The individual parts
include red blood cells, platelets, clotting factors, and
plasma.
Every person has one of the following blood types: A, B,
AB, or O. Also, every person's blood is either Rh-positive or
Rh-negative. The blood used in a transfusion must work with
your blood type. If it doesn't, antibodies (proteins) in your
blood attack the new blood and make you sick.
43. www.palnurse.com
Key Points
Blood banks collect, test, and store blood. They carefully
screen all donated blood so the right blood type is available
for your transfusion.
Many people who have surgery need blood transfusions
because they lose blood during the operation. People who
have serious injuries also may need blood transfusions to
replace lost blood. Some people need blood transfusions
because they have illnesses that prevent their bodies from
properly making blood or parts of blood.
44. www.palnurse.com
Key Points
Before a blood transfusion, a technician will test your
blood to find out what blood type you have. Your doctor
may prescribe medicine to prevent an allergic reaction.
Most patients don't need to change their diets or activities
before or after a blood transfusion.
When there isn't time to test for blood type (such as
during an emergency), type O blood is used. Type O is
safe for almost everyone.
Blood transfusions usually take place in either a doctor's
office or a hospital. The transfusion takes 1 to 4 hours.
The time depends on how much blood you need and what
part of the blood you receive.
45. www.palnurse.com
Key Points
After a blood transfusion, your vital signs are checked.
You may need blood tests that show how your body is
reacting to the transfusion.
Most blood transfusions go smoothly. However, mild
problems and, very rarely, serious problems can occur.
They include allergic reactions, transmission of viruses
and infectious diseases, fever, iron overload, lung injury,
reactions from receiving the wrong blood type, and
immune system problems.
46. www.palnurse.com
Key Points
There is currently no man-made alternative to
human blood. However, researchers have
developed medicines that do the job of some
blood parts. Research is ongoing to find a way
to make blood.
