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BLOOD COMPONENT
THERAPY
Presented by
Monika Devi
Msc(N)
HCN, SRHU
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.
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.
INDICATION
 After surgery , trauma or hemorrhage .
 Severe anemia.
 Leucopenia (↓se WBC).
 Agranulocytosis (bone marrow does not produce
enough or mature WBC)
BLOOD GROUP
Blood groups & their respective agents.
 Group : AB A B O.
 The group O is universal “donor”.
 The group AB is universal “recipient “.
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.
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
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
ARTICLES
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
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.
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
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
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
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
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
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.
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
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
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
CONT..
Other complications :-
 hematoma at site of the needle
 Thrombophlebities.
 Pulmonary embolism.
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.
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.
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.
SUMMARY
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.

THANK YOU

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bloodcomponenttherapy-190912083439.pdf

  • 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
  • 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.
  • 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. 