GOVT.
COLLEGE OF NURSING
M.B.S. HOSPITAL, KOTA
PROCEDURE
ON
BLOOD
TRANSFUSION
SUBMITTED TO:-
MR. GAJRAJ MEENA
H.O.D. OF MEDICAL SURGICAL
NURSING,
SUBMITTED BY:-
MR. INAMUDDIN AHMED
[Link]. NURSING, FINAL YEAR
BATCH – 2018-19
BLOOD TRANSFUSION_____________
DEFINITION
It is the transfusion of whole blood or its components such as blood cells and plasma
from one person to another person.
This involves two procedures-the collection of blood from the donor and the
administration of blood to the recipient.
PURPOSE
Restore blood volume when there is sudden loss of blood due to haemorrage; trauma
or burns.
To raise hemoglobin level in case of severe anemia.
To treat deficiencies of plasma proteins, clotting factors and hemophilic globulin.
To improve the leukocyte count of blood as in agranulocytosis.
To combat infection in patient with leucopenia.
GENERAL INSTRUCTIONS FOR GIVING BLOOD TRANSFUSION
SELECTION OF DONOR
Donor shall be free of diseases.
There should be no history of cancer TB jaundice hepatitis allergies etc.
They have not donated blood within the previous 90 days.
They should be physically healthy and should be between 18 and 65 years of age.
Donors must have normal vital signs.
They must not have been pregnant within the last 6-month.
Their HB level must be above 12 gm/100 ml.
Before the blood is transfused the ABO grouping and Rh typing with the recipient’s
blood should be done.
Before the blood is transfused donor’s blood must be cross-matched with the
recipient’s blood.
Donors blood immediately after it is withdrawn should be placed in the refrigerator
[temperature 1 to 6ْ c]
Transportation of blood in the hospital should be done within 30 min after it is taken
from the place of storage.
Freezing and heating of blood will destroy the blood cells
.
ADMINISTERATION OF BLOOD TO THE RECIPIENT
When sending the recipients blood sample for grouping and cross matching it
must be carefully labeled at bedside of recipient with the following indication
Recipients name
Hospital number
Bed number
Ward number
A request form should accompany the specimen and should contain the
following data
Recipients name
Hospital number
Bed number
Ward number
Name of physician
Exact amount of blood component
Diagnosis of patient
Any blood transfusion given earlier
It is essential that physician write all orders for typing, cross matching and
administration of blood and blood products.
Nurse should verify all the identifying information’s on the report of cross
match, unit label and patients identification
Blood and blood products must be administered through an appropriate sterile
transfusion set
Care to be taken to prevent introduction of air into the apparatus
No medication should be added
Adjust the flow rate to 8-10 drops/min during the first 30 minutes
Once the blood is exposed to the atmosphere it should be discarded
Following observations made are
Rate of flow
Circulatory overload
Urinary output
Patency
Reaction
Keep patient warm and comfortable
Record on nurses record with date and time
PREPARATION OF ARTICLES
ARTICLES PURPOSE
- Sterile transfusion set - To administer blood
- 18 gauge needle - To provide adequate rate of
flow
- To clean skin
- Sterile cotton swab
- Spirit - To clean skin
- Kidney tray and paper bag - To receive waste
- Tourniquet
- To occlude venous return
- Plaster with scissors
- To secure needle
- Mackintosh and towel
- To protect the linen
- IV pole
- To hang the bottle
- Green towel
- To cover bottle
PREPARATION OF PATIENT AND ENVIRONMENT
Explain the procedure to the client to win his/her confidence.
Send visitors out of patient room.
Ask patient to wash his hand with soap and water.
Provide privacy
.
Restrain the site in case of children.
Offer bedpan /urinal as needed.
Check vital signs.
Place the patient in comfortable position.
Keep IV stand in position.
Switch on the light and off the fan.
Call for assistance if necessary.
SCIENTIFIC PRINICIPLES
ANATOMY AND PHYSILOGY
The needle may be inserted under the top layer of skin, in to the loose tissue, in to
the muscles or in to a blood vessel.
Skin contains numerous blood vessels and nerves.
The walls of veins are elastic and they may dilate and contract when needle
enters.
MICROBIOLOGY
Wash hands thoroughly before and after procedure.
Use sterile articles.
Clean area to minimize infection.
PSYCOLOGY
Explain the procedure to win confidence.
Proper positioning.
Maintain privacy.
PROCEDURE
STEPS RATIONALE
- Explain the procedure to client - To win confidence
- Ask client to report chills, headache,
itching or rash.
- To minimize reaction.
- Be sure client has signed the consent
form.
- Wash hands. Wear gloves.
- To prevent infection
- To permit infusion of whole
- Establish IV line with large gauge blood
[18-19] catheter - And prevent hemolysis
- Use infusion tubing that has in line - Filter removes debris and tiny
filter clots from blood
- To prevent hemolysis of RBC
- Hang solution container of 0.9%
normal saline to be administered after
the blood transfusion
- To avoid error
- Identify correctly the blood product
and client
- To verify pre transfusion
- Obtain base line signs temperature, pulse, blood
pressure and respiration
- Begin the transfusion - To prevent hemolysis
- -Prime infusion line with 0.9% of
normal saline - To infuse transfusion properly
- -Begin transfusion slowly by first
filling the in line filter - To prevent further infusion of
- -Adjust rate to2ml/min for first 15 blood product
minutes .if any reaction stop
transfusion and flush the line
- To indicate any warning
- Monitor vital signs reaction
- Maintain prescribed infusion
rate using infusion pump - To maintain the rate
- Remove gloves and wash
hands - To prevent infection
- Observe for adverse reaction - Adverse reaction occur at any
point
- Record the administration of
blood and blood products - Documents administration of
blood components
- Return the blood bag and
tubing to the blood bank - Provides material for analysis
if reaction is later discovered
AFTER CARE OF PATIENT AND ARTICLES
Remove mackintosh and towel
Make patient comfortable
Collect all articles and take them to the utility room. Clean, wash replace them
Record the following information
Name and bed number
Time at which the drip was started
Type of blood
Amount of blood
Reactions observed
Medications administered
General condition of patient
COMPLICATIONS
1. GENERAL ADVERSE REACTION
-Acute hemolytic transfusion reaction
-Delayed hemolytic transfusion reaction
-Pyrogenic reaction
-Allergic reaction
-Anaphylactic reaction
-Transmission of infectious diseases
2. CIRCULATORY OVERLOAD
3. HYPERKALEMIA
4. HYPOCALCEMIA
OTHER COMPLICATIONS
Infiltration and haematoma
Thrombophlebitis
Pulmonary embolism
