NS3 Presents

A Seminar on Blood Transfusion

Presented by

Walter Tabora, RN
Gicel Barili, RN
Jeanilou Buslon, RN
OBJECTIVES
By the end of this lesson, the learner will be
able to:

 Nurses role in Blood Administration

 Define blood transfusion
 List commonly used blood components and products
 Identify types of blood
 Describe the clinical indication of each blood
component
 List common transfusion reaction
 Step by step procedure of blood transfusion including
GMMCI guideline
Nurses Role in Blood
Administration
1. Nurses are at the heart of blood management and
transfusion safety. Blood management programs do not
succeed without their support.
2. With an intimate knowledge of the patient’s status and
understanding of our hospital transfusion guidelines, nurses
can promote evidence-based transfusion practices.
3. Two of the three leading causes of death from transfusion
are directly associated with clinical blood administration
practices.
• An adult human has about 4-6 liters of
blood circulating in the body. Among
other things, the primary function of
blood is to transport oxygen to various
parts of the body

• Blood consists of several types of cells

floating around in a fluid called plasma
Blood Components
 plasma
 the liquid portion of the blood; our red, white blood cells and
platelets are suspended in plasma as they move throughout
the body. It also contains haemophilic factors

 red blood cells

 or erythrocytes, gives blood its distinctive color. Produced in
our bone marrow, they carry oxygen from our lungs to the
rest of our bodies. There are about one billion red blood cells
in two or three drops of blood.
 white blood cells
 or leukocytes, are one of the body’s defence against
bacteria and viruses or fight malignant disease

 platelets
 or thrombocytes, are small cell fragments in our blood whose
main function is to stick to the lining of blood vessels and
help stop or prevent bleeding.
What is Blood Transfusion?
 The transfer of blood or blood
components from one person (the
donor) into the bloodstream of another
person (the recipient). Blood
transfusions may be done as a life
saving maneuver to replace blood cells
or blood products lost through bleeding
or due to the depression of bone
marrow.
Blood Products
 Whole blood
• color: red
• Shelf life: 21-35 days
• Storage condition: Refrigerated
• Key uses: Trauma, Surgery
 Packed RBC
• Color: red
• Shelf life: up to 45 days
• Storage condition: Refrigerated
• Key uses: Trauma, Surgery,
Anaemia, any blood loss, blood
disorders such as sickle cell
 Platelets
• Color: colorless
• Shelf life: 5 days
• Storage condition: room
temperature with constatnt
agitation to prevent clumping
• Key uses: cancer treatments,
organ transplants, surgery,
platelet function abnormalities
 Plasma
 Color: yellowish
 Shelf life: 1 year
 Storage condition: frozen
 Key uses: burn patients, shock,
bleeding disorders
Donor and Recipient
Blood Antigen Antibodies Can give Can receive
Group blood to blood from
A A B A and AB A and O
B B A B and AB B and O
AB A, B NONE AB A, B, AB and
O
O NONE A, B A, B, AB, O O

Antibodies – are proteins found in plasma. They’re part of your body’s natural defences.
They recognize foreign substances such as germs, and alerts immune system which
destroys them.
Antigens – are protein molecules found In the surface of red blood cells.

Universal Donor – Type O

Universal Recipient – Type AB
The Blood Types
 A
 B
 AB
 O
 Each blood group can either be RhD positive or RhD negative,
which means there are eight main blood groups (A+, A-, B+, B-, O+,
O-, AB+, AB-)
 Your rhesus factor is fixed by your genes. If you’re rhesus positive
(RhD positive), it means that a protein (D antigen) is found on the
surface of your red blood cells. If you do not have the D antigen,
you will be rhesus negative (RhD negative).
Typing ang Crossmatching
 Before any blood can be given to a
patient. It must be determined that the
blood of the donor is compatible with the
patient. The laboratory examination to
determine a person’s blood group and
Rh factor is called blood typing. The
process of determining compatibility
between blood specimens is
Crossmatching.
Most common adverse effects of blood
transfusion
 Allergic
 Anaphylaxis
 Hemolytic
 Circulatory overload
 Non-hemolytic febrile transfusion
reactions
Allergic Reaction
 Symptoms: Urticarial rash and itch
within minutes
 Treatment
 Antihistamines
 and reduction of transfusion rate
Non-hemolytic febrile transfusion
reactions
 Results of alloimmunization of leukocyte and
platelet antigens
 Symptoms: Rigor followed by fever usually
within the start of 30-60 minutes of transfusion.
 Managed by cessation or slowing of
transfusion and administration of antipyretic
 Pretreated with antipyretic in repeated
transfusions and patient who has history.
 If above measure fauil, leukocyte-depleted cell
components are given.
Anaphylaxis
 Rare, fatal, caused by antibodies to IgA
in patients who have extremely low
levels of this immunoglobulin in plasma
(Hereditary IgA Deficiency), who have
been sensitized to IgA in previous
transfusions.
 Treatment: Termination of blood
transfusion, maintenance of airway,
oxygen, Adrenalin, I.V. antihistamines
and salbutamol.
Acute Hemolytic Reaction
 Result of ABO incompatibility
 Serious complication
 Mortality is high wen more than 200 ml has
been transfused.
 Clinical feature:
• Pain at the infusion site and along the vein
• Facial burning
• Chest and back pain
• Fever, rigor and vomiting
• Restlessness, breathlessness, flushing and hypotension
• Bleeding from vascular access and wound
Management
 Immediate recognition
 Cessation of transfusion
 Replacement of the blood transfusion set
 Adequate hydration
 Forced diuresis
 Vasopressor/Inotrope support might be required
 Further investigation
• Re-cross matching and serological testing
• Blood unit for culture
• Blood sample for clinical chemistry
• Coagulation screen
Circulatory overload
 Encountered when blood is
administered too rapidly or in large
volumes.
 Pulmonary edema is common
 Diuretics may be used – Furosemide
administered at incremental dosage of
20-40 mg depending on response 6-8
hourly until desired diuresis occurs.
 Blood Transfusion Procedure
(GMMCI guidelines)
1) Determine the doctor’s order in the patient’s chart
2) Explain the procedure to the patient and secure consent
3) Request for blood typing, if not available.
4) Fill up the blood request form (pink form) with the selection of appropriate blood
product and unit with the physician’s signature. Attach the blood typing result to the
pink form and handover the original copy to the patient and place the duplicate
copy to chart.
5) Help the family to find blood by checking the Center Information of Blood
Availability sheet.
6) Once blood is available, request for crossmatching or retyping (Crossmatching
result will be forwarded to nurse station by the MedTech)
7) Obtain vital signs prior to getting the blood from the laboratory. Fill the result in the
crossmatching form. Once VS is stable, you may get the blood from the laboratory.
8) Important! Have 2 Registered nurses check the blood and crossmatching result if it
matches.
9) Wash you hands, prepare the blood, introduce yourself to the patient and advise
the patient to report signs of BT reaction.
10) Monitor the vital signs during and after blood transfusion.
11) After blood transfusion, complete the cross matching form. Attach the original copy
to chart and send the duplicate to the laboratory together with the empty blood bag
(remove the tubing).
12) Document the procedure in the nurses notes.
THANK YOU!