DARWIN JEDRICK E.

PASCUA BSN 3E / GROUP 7-3/CGH

BLOOD TRANSFUSION the infusion of blood & blood products into the body circulation PURPOSE: 1. 2. 3. 4. To restore circulating blood volume To stop bleeding due to coagulation factor deficiencies To improve oxygen-carrying capacity of the blood To combat infection due to decreased white cells

EQUIPMENT: 1. 2. 3. 4. 5. Blood administration set Sterile needle gauge 18 or 19 Blood products as prescribed (PRBC, FWB, Platelet concentrate, plasma) Cotton ball with alcohol 0.9% NSS (normal saline solution) 1 unit of FWB = 500 ml 1 unit of PRBC = 250 ml 1 unit of Platelet concentrate or plasma = 50-70 ml PROCEDURE: 1. check the doctors order 2. secure the consent for transfusion 3. explain procedure to the patient. Advise patient to report any chill, itching, rash, DOB or unusual symptoms 4. wash your hands 5. hang container of 0.9% NSS with blood administration set to initiate IV infusion & follow administration of blood 6. start intravenous infusion with Gauge 18 or 19 catheter if not yet present. Keep IV open by starting flow of NSS

7. obtain the unit of blood to be transfused from the laboratory 8. check the patients identification number, blood group, blood type, expiration date, patients name and check for blood clots. You will check these with another nurse or nurse supervisor or with a doctor on duty 9. take baseline vital signs prior to beginning of transfusion (BP, RR, PR, Temp) 10. start infusion of blood product a. prime the in-line filter w/ blood b. start administration slowly (15gtts/min). Transfusion reaction usually occur during this period and a slow rate will minimize the volume of blood infused. If there has been no reaction during this time the infusion rate is increased (to be transfused within 4 hours) c. check vital signs every 5 minutes for the 1st 15 mins. d. Observe for flushing, dyspnea, itching, or rash. 11. maintain the prescribed flow rate as ordered 12. stop blood transfusion and allow NSS to flow if you suspect a reaction. The notify the physician and the blood bank or laboratory 13. continue transfusing 0.9% NSS when transfusion is completed and until further orders. 14. document the procedure like the time it was started and the patients reaction. DONTS IN BLOOD TRANSFUSION: 1) Do not store any blood component on a nursing unit or in an unmonitored refrigerator 2) Do not keep blood out of the transfusion service refrigerator for no longer than 30 minutes before starting the transfusion 3) Do not warm blood for transfusion in a microwave oven, under running water or in a sink 4) Do not heat blood components to a temperature higher than 38C 5) Do not transfuse a unit of blood over a period longer than 4 to 6 hours 6) Do not use the same blood filter, longer than 4 hours 7) Do not add drugs to blood components or infuse drugs and blood through the same blood administration set 8) Do not use any solution other than 0.9% NSS to prime a blood administration set, to flush the IV line or to dilute blood product