This document discusses blood transfusion, including indications, contraindications, types of blood components, preparation, nursing management, and risks. Blood transfusion is used to replace lost blood volume or components, and is indicated for anemia, bleeding disorders, major surgeries or trauma. Types of blood components include whole blood, packed red blood cells, platelets, and fresh frozen plasma. Nursing management involves preparing supplies, checking physician orders and blood compatibility, monitoring the patient during transfusion, and treating any potential complications. Risks include acute and delayed transfusion reactions with symptoms like hives, fever or pain.

2. CONTENTS
Introduction
Purposes
Indications
Contraindications
Types of blood content
Preparation for blood transfusion
Nursing management
Risk and complications

3. INTRODUCTION
 Blood transfusion is the process of transferring blood products
into a person's circulation intravenously.
 Blood transfusion should be undertaken when:
• Hemoglobin (Hb) < 7-8 gm/dl (American Association of blood
bank)
• Hb < 10 gram/dl and Hematocrit below 30 % for ongoing bleeding
during surgery or trauma (American Association of blood bank)
• Hb < 6 gm/ dl almost always indication (WHO)

4. PURPOSES
 To replace the blood volume
 To replace the needed component
 To meet the target level of blood and blood
components

5. INDICATIONS
 Low production of blood
 Major road traffic accident
 Chronic blood loss with anemia
 Conditions such as : bleeding disorders,
malignancies, coagulopathies, major surgeries,
severe burn

6. CONTRAINDICATIONS
 Whole blood is not indicated when
component specific therapy are needed &
chronic anemia
 For megaloblastic anemia (Vitamin B12
deficiency) transfusion may cause heart
failure or death

7. TYPES OF BLOOD CONTENT
Whole blood
 Obtained from donors & none of elements has been
removed or combined with anticoagulant
 Indication: Cases of severe hemorrhage and low
hemoglobin , to restore blood volume and when there is
no time for other preparation
 Duration/shelf-life : 35-42 days
 Storage and transportation temperature : +2° C to + 6° C
 Transfusion temperature : (37°c/98.6ºF)
 Transfusion duration : 2 to 4 hours

8. TYPES OF BLOOD CONTENT
Packed red cells (packed red blood
concentration / PRBC) / RCC
 Erythrocytes are separated from whole blood through
apheresis process
 Indication: post op acute bleeding, chronic severe
anemia, leukemia, thalassemia, congenital/acquired
anemic disorders
 Duration/shelf-life : 35-42 days
 Storage and transportation temperature : +2° C to + 6° C
 Transfusion temperature : (37°c/98.6ºF)
 Transfusion duration : 2 to 4 hours

10. TYPES OF BLOOD CONTENT
Platelet concentrates
 Platelets, or thrombocytes, are small, colorless cell
fragments in our blood whose main function is to stop or
prevent bleeding
 Indication: Bleeding due to platelets dysfunction,
Malignancy
 Duration/self-life : 4-7 days
 Storage and transportation temperature : +20° C to + 24° C
 Transfusion temperature : (37°c/98.6ºF)
 Transfusion duration : 1-2 hours

11. TYPES OF BLOOD CONTENT
Fresh Frozen Plasma (FFP)
 Separated from unit of blood which contains water,
electrolytes, coagulation factors, and protein
 Indication: To treat bleeding disorder, for factor v
deficiency, antithrombin III deficiency, treatment of
immunodeficiency
 Duration/self-life : 1 year (storage condition frozen)
 Transfusion temperature : (37°c/98.6ºF)
 Transfusion duration : 1 hour
 FFP : no need of x-match
 FFP volume - 150-300ml

12. Preparation for blood transfusion
(Articles required)
A clean tray containing articles
 For vein open : alcohol swab, torniquet, cannula
(16/18G), IV set, NS, adhesive tape, scissors,
roller bandage and splint if needed, IV stand
 Vital signs: Blood pressure set, thermometer,
portable Saturation probe
 Disposable bag/kidney tray, gloves, specimen
container
 Different size syringe with needle (3ml,5ml,10ml)
 Lifesaving drugs

13. Preparation for blood transfusion
(Articles required)

14. NURSING MANAGEMENT
BEFORE PROCEDURE
 Identify the patient
 Check the physician’s order, patient condition and past
history of transfusion reaction
 Obtain blood from blood bank
 Explain patient about the procedure, need for transfusion and
approximate length of time
 Obtain informed consent from the patient/ patient party
 Bedside curtain / close the door

15. NURSING MANAGEMENT
BEFORE PROCEDURE
 Wash and dry hands
 Prepare required articles
 Identify the patient’s condition by taking vital
signs and document pre-transfusion vital signs in
patients file
 Check for type of blood and compatibility
 Ensure the patient to empty bowel and bladder and
collect urine specimen
 Keep the patient in comfortable position

16. NURSING MANAGEMENT
DURING PROCEDURE
 Wash and dry hands
 Vein open
 Inspect the blood product by
2 nurses
• Patient’s name
• Blood group and type
• Collection date
• Expiry date
• Identification number
• Compatibility
• Abnormal color, clots

17. NURSING MANAGEMENT
DURING PROCEDURE
 Warm blood if needed using special blood warmer
 If blood product is found to be correct, stop the saline
solution and start the blood transfusion
 Start blood product slowly at the rate of 2ml/ minute.
Remain at bedside for 15-30minutes,check the vital
signs every 15 minutes according to hospital policy
 Increase infusion rate if no adverse reactions are
noticed.

18. RISK AND COMPLICATIONS
ACUTE REACTION DELAYED REACTION
Reaction occurring during the
transfusion or within 24
hours
Reaction occurring >24 hours
after the start of the transfusion
Can be seen up to 30 days of
post-transfusion
Symptoms : flushing,
urticarial, anxiety, vomiting,
headache, back pain, edema,
hives and itching
Symptoms : nausea, fever,
chills, chest and lower back
pain, and dark urine

19. Urticaria

20. If complication occurs
 Stop the transfusion immediately
 Start IV fluid
 Consult duty doctor
 Send both recipient and donor blood specimen
for repeat grouping and X matching
 Most allergic reactions, this can be treated with
antihistamines
 Monitoring the patient's vital signs before and
during the transfusion is important to identify
reactions promptly

23. REFERENCES
 Continuous professional development module for nurses, Nursing and
Social security division, DoHS, MoHP, 2020.
 College, U., 2023. Step-by-Step Master’s Guide to Blood Transfusions.
Unitek Coll. URL https://www.unitekcollege.edu/blog/a-step-by-step-
guide-to-blood-transfusion/ (accessed 12.26.23).
 Blood Transfusion Reaction - an overview | ScienceDirect Topics [WWW
Document], n.d. URL https://www.sciencedirect.com/topics/medicine-and-
dentistry/blood-transfusion-reaction (accessed 12.29.23).
 Blood transfusion: Types, purpose, procedure, and recovery, 2020.
URL https://www.medicalnewstoday.com/articles/327513 (accessed
12.26.23).
 fresh-frozen-plasma-factsheet-april-2021-v5.pdf, n.d.
 Blood Components, URL https://www.redcrossblood.org/donate-
blood/how-to-donate/types-of-blood-donations/blood-components.html
(accessed 12.27.23)