Blood transfusion

1. BLOOD COMPONENT
THERAPY
Presented by
Monika Devi
Msc(N)
HCN, SRHU

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

9. ARTICLES

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

21. CONT..
Other complications :-
 hematoma at site of the needle
 Thrombophlebities.
 Pulmonary embolism.

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.

25. SUMMARY

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.


27. THANK YOU