BLOOD TRANSFUSIONBY UMA J DEAVER

BLOOD TRANSFUSION

DEFINITION

Blood transfusion is the intravenous administration of the whole blood or a

component such as plasma, packed red blood cells or platelets to a patient.

Homologous transfusion:transfusion of blood that is take from the other human beings (donor) & stored.

Auto logous transfusion:it is the refusion of a patient’s own blood

Tranfusion of plasma expanders and blood components.

THREE MODALITIES TO REPLACE BLOOD LOSS

To increase circulating blood volume To increase the number of red blood cells

and to maintain the haemoglobin level. To provide plasma clothing factors, to help

in controlling bleeding. To combat infection due to decreased or

defective white cells or antibodies.

PURPOSES

After surgery, trauma or haemorrhage

Severe anaemia

Haemophilia

Leucopoenia

Agranulocytosis

Throblastosis fetalis

INDICATIONS

It must not be outdated (21 days) Blood should be warmed to 35c before

transfusion. Blood can be left ½ hr at room temperature.

THINGS KEPT IN MIND

GROUP AGGLUTINOGENS IN THE RED CELLS

AGGLUTINIS IN THE PLASMA

AB A and B No agglutinins(-)

A A Beta agglutinins (b)

B B Alpha agglutinins (a)

O No agglutinogens Both alpha & beta (ab)

BLOOD GROUPS AND THEIR RESPECTIVE ANTIGENS

Should not be suffering from disease of heart, kidneys,liver,lungs,cancer,jaundice, tuberculosis, hepatitis, AIDS, allergies etc.

Should not have donated blood within the previous 90 days.

Should be healthy and in the age group o 18-65 years.

Should not be pregnant. Should have HB level above 12gm% Should have normal vital signs (TPR BP) Should not be empty stomach.

SELECTION OF DONOR

PREPARATION OF THE RECIPIENT Explain the procedure to the patient. Determine whether the patient has undergone prior

transfusion and reactions,if any. Get an informed consent from the patient/ relation. Provide a comfortable position. Prior to administration of blood, the patient’s vital

signs should be recorded correctly Check & Ask the patient to report chills,

headaches,itching, or rash immediately so that prompt reporting and discontinuation of transfusion can be done.

PROCEDURE

Wash hands, wear gloves Identify the accessible veins Check the blood to be transfused for group.(Rh type, expiry

date,etc) Open the sterile packing of blood transfusion set aseptically Place tourniquet 10-12cm above the insertion site by asking

the patient to clench his fist . Clean the insertion site with iodine or spirit. Insert the needle and start infusion . Begin transfusion after identify the blood product and the

patient thoroughly. Adjust rate to 2ml/min for first 15 min , and remain with the

patient Monitor vital signs every 5 min for first 15 min and every

hour thereafter Remove and dispose of gloves and wash hands Record administration of blood ,date ,time ,blood

group ,adverse reaction and amount of blood infused .

STEPS OF PROCEDURE

Haemolytic transfusion reaction Pyrogenic reactions

Allergic reactions

Circulatory overload

Transmission of infection diseases

Anaphylactic reactions

COMPLICATIONS OF BLOOD TRANSFUSIONS

It occurs within 1 to 2 hrs and within 24 hrs. It is rapid destruction of donor RBCs by host

antibiodes (IgG, IgM)SIGN & SYMPTOMS:fever, hypotension,

anxiety, and later sign red colour urineMANAGEMENT: Discontinue the blood transfusion Check BP for hypotension Prophylactic measures to reduce the risk of

renal faiure as per doctor order.

Hemolytic transfusion reaction:

It occurs within mints or upto 24 hrsSIGN & SYMPTOMS Fever, flank pain, redish brown urine, acute renal

failureMANAGEMENT Check BP Prevent renal failure Infuse normal saline as per doctor order Maintain urine out put more than 100 to 200 ml/hr Cardiac monitoring ABC if needed

Pyrogenic reaction