Maternity

1. Blood
components
and
transfusion
By : Mosab Abu-Saraya
Noor-Aldeen Naser
Moderator by : Dr.Marah

2. Outline

3. Objective

4. Blood
Blood is a fluid in the human body that
transports essential substances such as
nutrients and oxygen to the cells and
transports metabolic waste products such
as carbon dioxide away from those same
cells. It consists of red blood cells, white
blood cells, plasma and platelets, and its
normal temperature is 37 degrees
Celsius. Blood makes up 8% of the body
mass.

5. Bloodcomponent
• Platelets• Plasma • WBC • RBC

6. Whole blood
Whole blood contains all blood
components and is usually transfused
to people who need both red blood
cells and volume replacement, A unit
of whole blood is approximately 85mL

7. ●Red blood cells contain a protein called
hemoglobin, which carries oxygen from
your lungs to all parts of your body.
Hemoglobin is what makes your blood red
. Red blood cells also help remove waste
products from your body, such as carbon
dioxide.
RBCs

8. ● A WBC count is a blood test to measure the
number of white blood cells (WBCs) in the blood.
It is a part of a complete blood count (CBC).WBCs
are also called leukocytes. They help fight
infections. There are five major types of white
blood cells : Basophils , Eosinophils ,
Lymphocytes (T cells, B cells, and Natural Killer
cells) Monocytes Neutrophils .
WBCs

9. Platelets transfused more than any other blood
component consist of platelet concentrates and
platelets –rich plasma
*The major function of platelets is to participate in
blood clotting and hemostasis
One common indication for platelet transfusion is
thrombocytopenia following chemotherapy

10. ● Plasma is a light fluid in the blood without blood cells, but
containing proteins and other components of whole blood
in suspension, making up about 55% of the body's total
blood volume. It is the intravascular portion of extracellular
fluid (all body fluids outside cells). It is composed mostly of
water (up to 95% by volume), contains important dissolved
proteins (6-8%) (e.g. serum albumin, globulin, fibrinogen),
glucose, clotting factors, and electrolytes (Na+, Ca+2, Mg+
2, HCO3-, Cl- and others), hormones, carbon dioxide
(plasma is the main means of transporting secretory
products), and oxygen.
Plasma

11. Blood transfusion refers to the
introduction of whole blood or blood
components (packed red cells,
plasma, platelets) directly into a
client's circulatory system

13. INDICATION
serious injury that’s
caused major blood loss
Surgery that’s caused a
lot of blood loss
A liver problem that
makes the body unable
to create certain blood
parts
A bleeding disorder such
as hemophilia
An illness that causes
reduced or poor-quality
RBCs (anemia)
Kidney failure, which
causes problems with
blood cell production
Treatment for cancer
(chemotherapy) that
slows down the body’s
production of blood cells
Hematologic
disorders such as
sickle cell disease,
thalassemia&G6PD

20. blood
transfusion

21. Purpose

23. Equipment
v Packaged blood component from blood bank
according to agency protocol
v 250-mL IV container of sterile 0.9% normal
saline
v Blood administration set with filter
v Blood warmer and pressure bag may be used if
infusing large volumes of blood rapidly
v IV pump (certified to be used to administer
blood components)
v Alcohol swabs and tape

24. Procedure
v Explain procedure to client or clint family . have client family
sign consent form if required by hospital policy.
v Obtain client's vital signs including temperature(every five
minute )
v Rationale: Baseline pretransfusion vital signs can be
compared against vital signs taken during and after
transfusion to detect reactions
v With another RN, an MD, or other licensed staff at the
client's bedside, verify the blood component and the client's
identity by comparing the laboratory blood record with:
The client's name and identification number both verbally and
against The blood unit number on the blood bag label client's
identification band.

25.  The blood group and Rh factor on the blood bag
label.
 Also verify the kind of blood component and the
expiration date noted on the blood label.
Document verification by both RN signatures
on transfusion record.
 Wash your hands.
 Rationale: Prevents transmission of
microorganisms.
 Open Y-type blood administration set, and
clamp both rollers completely.
 Spike blood component unit bag port. Prime dip
chamber and tubing with blood component.

27. v Observe and document
client's condition during first
15 minutes, assessing for
chilling, back pain, vomiting,
tachycardia, hypotension,
nausea or tachypnea, or
skin rash.

28.  If no adverse reactions occur after 15 minutes,
regulate clamp to increase infusion according to
physician's orders. A unit of red blood cells is usually
administered over 2 to 4 hours. Observe the patient
for signs and symptoms of transfusion reaction at
least every 30 minutes throughout the transfusion.
Obtain vital signs when observations warrant.
Document observations of the client in the medical
record.
 When blood transfusion is complete, clamp roller to
blood and open roller to 0.9% NaCl. Infuse until
tubing is clear (usually no more than 50 mL of normal saline).

29.  If transfusion orders are complete,
disconnect the blood administration
tubing from the IV catheter hub.
Reconnect the primary IV solution and
tubing and adjust to desired rate.
 Wash hands and document procedure.
 Rationale: Facilitates communication
with healthcare team.

31. Acute hemolytic transfusion reactions, the most serious of the
acute complications, can be life threatening. A hemolytic
transfusion reaction occurs at a time when the donor's blood is
incompatible with the recipient's blood. This can occur if even a
small amount of incompatible blood is mistakenly administered
to client. Hemolytic, or destruction of RBCs, occurs when the
antibodies in the recipient's blood quickly react to the donor's
blood cells
Symptoms, which are immediate ,include facial flashing , fever,
chills, headache, low back pain , tachycardia, dyspnea,
hypotension, and blood in the urine.

32. to blood components can occur because of the recipient's hypersensitivity to the
donor's white blood cells.
In this reaction, the client develops a fever and chills and may complain of headache
and malaise.
Sometimes, the client receives antipyretics before the transfusion to prevent the
shaking and chills.
If symptoms occur after the infusion has started, stop the transfusion immediately
and keep the IV open with normal saline. Notify the physician and monitor vital signs

34. can occur if bacteria have contaminated the blood components. These
reactions are most often seen in clients receiving contaminated single-
donor apheresis platelet transfusions because all platelets are stored at
room temperature (20–24°C) for as long as 5 days.
The client will likely have a rapid onset of fever and chills and perhaps
vomiting, diarrhea, and hypotension.
If this occurs, stop the transfusion and notify the physician.
To minimize time for bacterial growth within the blood component,
refrigerate red blood cell and defrosted fresh frozen plasma until used
and then infuse within 4 hours.

35. Fluid overload
can occur when blood components are infused too quickly or too
voluminously. Transfusion-associated circulatory overload (TACO) is
more likely in the very young or the older adult with poor cardiac or renal
function.
Symptoms include increased venous pressure, distended neck veins,
dyspnea, coughing, and abnormal breath sounds. Circulatory overload
can be minimized by infusing packed RBCs (rather than whole blood) and
volume reduced platelets
for high-risk clients and carefully monitoring the infusion rate of blood
components. If transfusion-associated circulatory overload is suspected,
slow the infusion of blood, position the client in an upright position , and
notify the physician

36. ● Always monitor vital signs before starting the
infusion and during the first 5 minutes(in the
first 15 minute ) when the blood is infusing
slowly. If you suspect a hemolytic reaction,
stop the transfusion immediately and keep
the IV open with normal saline
Nursing role

37. Reference
● https://repository.poltekkes-kaltim.ac.id
/638/1/Wong%e2%80%99s%20Essentials%20of%20Pediatric%20Nursing%20by%
20Marilyn%20J.%
20Hockenberry%20Cheryl%20C.%20Rodgers
%20David%20M.%20Wilson%20(z-lib.org).pdf
● https://pubmed.ncbi.nlm.nih.gov/17302766/
● https://youtu.be/km99Mw7LoPY?si=exMAeWwuUiMh-U13