2. DEFINITION
Blood transfusion is the IV
administration of whole
blood or its component
such as plasma , packed red
blood cells or platelets to
correct or treat any clinical
condition of a patient.
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. INDICATION
After surgery , trauma or hemorrhage .
Severe anemia.
Leucopenia (↓se WBC).
Agranulocytosis (bone marrow does not produce
enough or mature WBC)
5. BLOOD GROUP
Blood groups & their respective agents.
Group : AB A B O.
The group O is universal “donor”.
The group AB is universal “recipient “.
6. PRE-TRANSFUSION ASSESSMENT
1. Patient history of previous transfusion ,
reactions to transfusions ,
No. of pregnancies a women has ,
health problem ,
cardiac , pulmonary & vascular diseases.
2. Physical assessment –
baseline vital signs ,
auscultation of lungs & patients use of accessory muscles ,
edema , jugular vein distention ,
skin rashes , echymosis, etc.
3. Patients teaching :
patient should be taught about the sign & symptoms of adverse
reactions.
7. PREPARATION OF RECIPIENT
Explain the procedure to the patient & relatives
Ask whether he/she has undergone prio transfusion &
reactions
Take informed consent from the patient/relative
Provide comfortable position to the patient
8. CONT…
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. PREPARATION OF ARTICLES
1. A tray containing :
2. A blood transfusion set
3. A mackintosh & A towel
4. A tourniquet ,
5. Cotton swabs with Antiseptic
6. Adhesive tape & scissors ,
7. Gloves ,
8. kidney tray .
9. IV stand
10. NS,
11. Paper bag ,
12. Blood or any of it components
with cover received from
blood bank with the name of
recipient
11. PROCEDURE
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.
12. CONT..
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
13. CONT…
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
14. CONT…
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
15. 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
16. CONT…
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
17. COMPLICATIONS OF BT
1. 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.
18. CONT…
2. Pyogenic 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 tubing, characterized by fever with chills , nausea ,
vomiting , diarrhea , headache , backache , delirium , shock &
renal failure
19. CONT…
3. Allergic Reactions :
There are due to individual sensitivity to plasma proteins
characterized by itching , laryngeal edema & bronchial spasms
4. 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
20. CONT…
5. Transmission of infectious diseases :
Various diseases like hepatitis, AIDS , malaria , syphilis etc. are
transmitted through blood when not properly checked.
6. Anaphylactic reactions :
These occur rarely but are life threatening condition
characterized by a severe respiratory & cardio-vascular
collapse , severe GI disturbances
22. NURSING MANAGEMENT REGARDING
COMPLICATION OF BLOOD TRANSFUSION
If occur : -
Stop the transfusion immediately
Notify the physician
Connect the Iv line with 0.9% normal saline.
Be with the client, observe the sign and symptoms and
monitor the vital signs till they becomes stable.
23. CONT…
Get ready the emergency drugs such as vasopressor ,
antihistamine, steroid, and fluids.
Obtain a urine specimen and send to the laboratory.
Save the blood container and tubing for return to the bank .
Document the reactions and measures carried out.
24. NURSING RESPONSIBILITIES
Nurse is responsible for safety and effectively administering i/v
infusion.
Nurse must have legal knowledge about infusion.
Nurse should do through assessment of patients physical codition ,
medical history, allergies and dietary pattern.
Nurse should have knowledge about calculation of flow rate and
methodical.
Nurse should apply physiological, anatomical and aseptic principles.
Nurse should have vigilant observation through out the procedure so as
to prevent adverse reactions which can sometimes be fetal.
26. REFERENCES
Janne v. hickey the clinical procedure of nursing 6th edition
2009, page no . 435-436.
Annamma jacob, clinical nursing procedure . The art of nursing
practice second edition 2010.page no .435.
