Transfusion Therapy (Blood)

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 due
to a serious injury. A transfusion also may be done if your body can't
make blood properly because of an illness.

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.
• An illness that causes anaemia, such as kidney disease or
cancer. Medicines or radiation used to treat a medical condition
also can cause anaemia. There are many different types of
anaemia, including aplastic, Fanconi, haemolytic, iron-deficiency,
and sickle cell anaemias and thalassaemia.
• A bleeding disorder, such as haemophilia or thrombocytopenia.

Purpose:
 To administer required blood component by the client
 To restore the blood volume
 To improve oxygen-carrying capacity of the blood

Procedure

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.

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.

Type O blood is safe for almost everyone. About 40 percent of the

population has type O blood. People who have 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 who have type AB blood are called universal recipients. This
means they can get any type of blood.

If you have Rh-positive blood, you can get Rh-positive or Rh-negative

blood. But if you have Rh-negative blood, you should only get Rh-
negative blood. Rh-negative blood is used for emergencies when
there's no time to test a person's Rh type.
Blood Components
Whole Blood
• Contains all blood components and is usually transfused to
people who need both red blood cells and volume
replacement. A unit of this is approximately 500 ml.
Packed Red Blood Cells (PRBC)
• Contain a concentration of RBCs with most plasma
removed. A unit packed RBC is approximately 250 ml. This
provides the same oxygen carrying capacity as whole
blood but without the volume.
• You may need a transfusion of red blood cells if you've lost
blood due to an injury or surgery.
White Blood Cells (WBC)
• Also called granulocytes, can be administered to a client
with low or abnormal WBC count. Infusion of EBC is helpful
in fighting infection.
Platelets
• Transfused more than any other blood component, consist
of platelet concentrates and platelet rich plasma. Major
function is to initiate blood clotting and hemostasis.
Fresh Frozen Plasma
• Is administered to provide clotting factors to clients with
coagulation deficiencies who are bleeding or about to
undergo on invasive procedure.
• If you have been badly burned or have liver failure or a
severe infection, you may need a plasma transfusion.
Albumin
• Is a plasma protein contained within the plasma. It is used
to restore intravascular volume and to maintain cardiac
output in clients with hypoproteinemia.
Cryoprecipitate
• plasma protein rich in fibrinogen and blood clotting factor
• >concentrated from many units of blood and administered
to control bleeding in clients with fibrinogen deficiencies,
such as those with hemophilia.

Nursing Interventions:
1. Verify doctor’s order.
2. Check for cross-matching and blood typing.
3. Obtain and record baseline V/S
4. Practice strict ASEPSIS
5. At least 2 nurses check the label of BT
 Serial number
 Blood component
 Blood type
 Rh factor
 Expiration date
 Screening tests: VDRL, HBsAg, malarial smear
6. Warm blood at room temperature
7. Identify client properly
8. Use needle g. 18 or 19
9. Use BT set with filter
10. Start infusion slowly at 10 gtts/min. Remain at bedside for 15 to 30
minutes
11. Monitor V/S
12. Do not mix medication with BT
13. Administer PNSS before, during and after BT
14. Administer BT for 4 hours (FWB, PRBC). For plasma, platelets,
cryoprecipitate, transfuse quickly (20 min) clotting factors can easily
be destroyed

Complication:
1. Allergic reaction
2. Febrile, Non-hemolytic
3. Septic reaction
4. Circulatory overload
5. Hemolytic reaction
 Low back pain (first sign)

Nursing Interventions During Complications

1. Stop BT immediately
2. Start IV line (PNSS)
3. Collect urine specimen
4. Monitor V/S
5. Send unused blood and BT set to the blood bank
6. Administer antihistamine, diuretics and bronchodilators as
ordered
7. Make relevant documentation