Whole blood, packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate are the main blood components used for transfusions. Each component has a specific composition and purpose. Whole blood contains all blood components and is used for volume replacement after significant blood loss. Packed red blood cells contain mostly red blood cells and increase oxygen carrying capacity, while fresh frozen plasma contains clotting factors to treat bleeding disorders. Platelets help stop bleeding and cryoprecipitate contains high levels of factor VIII and fibrinogen. Nurses must closely monitor patients during transfusions for signs of reactions and ensure appropriate screening, consent, and administration of blood products.
blood transfusion is a life saving procedure. so role of nurse here while transfused the blood in the ward is important. in this slide role of nurse is given here. if you like kindly give your comment and share it to others. follow my account to know more.
blood transfusion is a life saving procedure. so role of nurse here while transfused the blood in the ward is important. in this slide role of nurse is given here. if you like kindly give your comment and share it to others. follow my account to know more.
Selection of blood donor is the foremost and most important part in ensuring safe blood supply, donor selection guidelines has been revised by NBTC from time to time, this upload is of 2017
Define blood transfusion
Enlist the purpose of blood transfusion
Brief the history of blood transfusion
Describe various component of blood
Understand types of blood transfusion
Perform the steps of the procedure
Recognize the adverse reaction of blood transfusion
Lecture By:
Dr Hisham Fakher
Consultant Hematology
Medical Director of Regional Laboratory and Central Blood Bank
Ministry of Health –Almadinah Almonawarah
Blood transfusion therapy
• A Blood Transfusion is the infusion of whole blood or a blood
component such as plasma, red blood cells, or platelets into
the patient’s venous circulation.
• A blood transfusion is given because of red blood cell loss,
such as with haemorrhage or when the body is not
adequately produce in a cells such as platelets. The person
receiving the blood is the Recipient.
Selection of blood donor is the foremost and most important part in ensuring safe blood supply, donor selection guidelines has been revised by NBTC from time to time, this upload is of 2017
Define blood transfusion
Enlist the purpose of blood transfusion
Brief the history of blood transfusion
Describe various component of blood
Understand types of blood transfusion
Perform the steps of the procedure
Recognize the adverse reaction of blood transfusion
Lecture By:
Dr Hisham Fakher
Consultant Hematology
Medical Director of Regional Laboratory and Central Blood Bank
Ministry of Health –Almadinah Almonawarah
Blood transfusion therapy
• A Blood Transfusion is the infusion of whole blood or a blood
component such as plasma, red blood cells, or platelets into
the patient’s venous circulation.
• A blood transfusion is given because of red blood cell loss,
such as with haemorrhage or when the body is not
adequately produce in a cells such as platelets. The person
receiving the blood is the Recipient.
The Donor Selection Criteria slide is a bold step in helping professionals understand the various stages of strict scrutiny an individual needs to be subjected to in order to regarded a qualified donor for donate blood.
In this presentation, we will also spend some time going through the various World Health Organization(WHO) donor selection criteria and finally there are links for additional resources you can click to visit.
DEFINITION OR MEANING OF MENSTRUAL (REPRODUCTIVE) CYCLE:-
Menstruation (Greek word, men-month) is monthly uterine bleeding out flowing through vagina into vulva for 4-5 days every 28 days (24-35 days)during reproductive life of a woman from menarche to menopause.
The Menstrual cycle of 28 days starts on day of onset of menstruation and ends at day 28 on start of next mens.
The cycle consists of a series of changes taking place concurrently in the ovaries and uterine lining, stimulated by changes in blood concentration of hormones.
General Physiological changes during puerperiumPRANATI PATRA
introduction
Estrogen and progesterone levels decrease markedly after expulsion of the placenta, reaching their lowest levels 1 week into the postpartum period.
The estrogen levels in non lactating women begin to increase by 2 weeks after birth, and higher by postpartum day 17.
If trauma to the urethra and bladder occur during the birth process, the bladder wall becomes edematous, often with small areas of hemorrhage.
Birth-induced trauma increased bladder capacity and the effects of anesthesia combine to cause a decrease in the urge to void.
introduction
anatomy and physiologic changes-UTERUS: At the end of third stage of labour, the uterus is in the midline , about 2cm below the level of umbilicus and weight 1000g
INTRODUCTION
DEFINITION
TYPES
CAUSES
MANAGEMENT-Management of 3rd stage bleeding
Actual management
MANAGEMENT OF 3RD STAGE BLEEDING
Steps of management
1. Placental site bleeding-
To palpate the fundus and massage the uterus to make it hard. The massage is to be done by placing four fingers behind the uterus and thumb in front.
To start crystalloid solution (NS or RL) with oxytocin (1L with 20 units) at 60 drops per minute and to arrange for blood transfusion if necessary.
Oxytocin 10 unit IM or methergine 0.2 mg is given intravenously.
To catheterize the bladder.
To give antibiotics (Ampicillin 2gm and Metronidazole 500mg IV)
2. Management of traumatic bleed
The uterovaginal canal is to be explored under general anesthesia after the placenta is expelled and haemostatic sutures are placed on the offending sites.
STEPS OF MANUAL REMOVAL OF PLACENTA
The patient is placed in lithotomy position. With all aseptic measures, the bladder is catheterized.
One hand is introduced into the uterus in cone shaped manner following the cord. While introducing the hand, the labia are separated by the fingers at the other hand.
Counter pressure on the uterine fundus is applied by the hand placed over the abdomens. The abdominal hand should steady the fundus and guide the movement of the fingers inside the uterine cavity till the placenta is completely separated.
Taking-In Phase
It takes 2-3 days, during which time the mother’s first concern is with her own needs (sleep and food).
The woman reacts passively, mostly dependent on others to meet her needs.
She is quite talkative during this phase about every detail of her labor and delivery experience
Taking-Hold Phase (Taking Responsibility as a Mother)
It starts the 3rd day postpartum
She progresses from the passive individual to the one who is in command of the situation.
This phase lasts about 10 days.
Once the mother has taken control of her physical being and accepted her role as a mother, she is able to extend her energies to her mate and other children.
Letting-go Phase
This generally occurs when the mother returns home.
In this phase there are two separations that the mother must accomplish.
One is to realize and accept physical separation from the infant. The other is to relinquish her former role as a childless person and accept the enormous implications and responsibilities of her new situation.
Letting-go Phase
This generally occurs when the mother returns home.
In this phase there are two separations that the mother must accomplish.
One is to realize and accept physical separation from the infant. The other is to relinquish her former role as a childless person and accept the enormous implications and responsibilities of her new situation.
Physical Assessment is necessary to identify individual needs or potential problems
Explain to pt purposes of the examination.
Obtain her consent.
Record your findings and report results to the mother.
Ensure privacy and environment where the mother can lie on her back with her head supported.
Ensure bladder is empty & lay patient supine with legs flexed.
The midwives hands should be clean and warm
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
AMNIOINFUSION--
definition-An amnioinfusion is a technique of instilling an isotonic fluid {such as a normal saline or lactated ringer’s solution} into the amniotic cavity during labor to relieve umbilical cord compression and alleviate fetal distress from severe prolonged variable decelerations in the presence of oligohydramnios.
INDICATIONS
Fetal heart rate abnormalities
APGAR scores for those with low scores
Asphyxia during time of birth
Decreasing the rates of cesarean birth related with FHR problem
PROCEDURE
The amnio infusion procedure involves the use of an intrauterine pressure catheter (IUPC), or a single or double lumen type of IUPC.
The IUPC has been designed to attain an accurate monitoring of uterine contractions among women in the intrapartum period.
It has a special port from which the saline fluid or lactated ringer’s solution is being injected, passing through the tubing and going its way into the uterus.
An IUPC is inserted through standard technique once the membranes ruptures, and then it is attached to intravenous extension tubing. If IUPC is not available, a pediatric nasogastric tube can be used instead.
Lactated ringer’s solution without dextrose is infused into the amniotic cavity; normal saline can be an acceptable fluid alternative
Assisting Physician with Amnioinfusion
Explain the procedure to the patient.
Assist in dorsal recumbent position. Assist with draping and exposing vaginal area.
Connect IUPC tubing to IV fluid, flush
Connect the catheter to the monitor cable
Assist physician with insertion of double lumen IUPC and connect IV tubing to the amnioport to begin amnioinfusion.
The placenta is said to be retained when it is not expelled from the uterus even 30 minutes after the delivery of the baby
Manual placenta removal is a procedure to remove a retained placenta from the uterus after childbirth.
Mannual removal of placenta is done under GA.
Patient placed in lithotomy position
Bladder is catheterized
newborn assessment-
intriduction-Definition of neonatal period:
A period from birth 4 weeks postnatal.
The exam will cover the following:
Record date and time of exam
General assessment and measurements
Skull bones
Face
Mouth & palate
Nose
Ears
Eyes
Chest
Abdomen
Arms
Hands
Legs
Feet
Genitals
Anus
Spine
Skin
reflxes-
Obsterics and Gynaecology-
introduction-Preventive obstetrics is the concept of prevention or early detection of particular health deviations through routine periodic examinations and screening .
The concept of preventive obstetrics concerns with the concepts of the health & wellbeing of the mother her baby during the antenatal,intranatal & postnatal period.
The goal of the preventive obstetrics is the delivery of a healthy infant by a healthy mother at the end of a healthy pregnancy.
Pregnancy & child birth normal physiological
process that change from conception to
delivery.
Objectives
To promote , protect and maintain the health of the mother during pregnancy.
To detect “high risk” cases and give them special attention
To foresee complications and prevent them.
To remove anxiety and dread associated with delivery
physiology and management of third stage of labourPRANATI PATRA
OBSTETRICS & GYNAECOLOGICAL NURSING
physiology and management of third stage of labour-introduction
labour
stages of labor
physiology
management of third stage of labour.
OBSTETRICS & GYNAECOLOGICAL NURSING-
MINOR AILMENT DURING PREGNANCY-
INTRODUCTION-Many women experience some minor
disorder during pregnancy.
These disorder should be treated adequately as they may escalate and become life-threatening.
DEFINITION-“The minor complaints of pregnant women that occur due to physiological alterations of hormones and other causative factors which can be managed without medical interventions.”
- Every system of body may affected by pregnancy.
OBSTETRICS & GYNAECOLOGICAL NURSING
GENETIC COUNSELLING DURING PREGNANC
INTRODUCTION-
COUNSELLING-Counselling is consultation, mutual interchange of opinions, deliberating together.A process in which the counsellor assist the counselee .
Provides concrete, accurate information about inherited disorders.
Provides information about prognosis and follow up.
Discuss ways in which disease can be prevented.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
6. Whole Blood
Composition:
-Red Blood Cells
-White Blood Cells
-Plasma
-Platelets
-Hematocrit
-Clotting Factors
ONE UNIT OF WHOLE BLOOD CONTAINS -
•450 ml OF DONOR BLOOD.
•50 ml OF ANTICOAGULANT-PRESERVATIVE SOLUTION.
•HAEMOGLOBIN approx. 12g/ml & HAEMATOCRIT 35% -
45%.
•NO FUNCTIONAL PLATELETS
7.
8. Packed Red Blood Cells (RBCs)
• Composition:
- RBCs with little plasma (hematocrit about 75%)
- Some platelets and WBCs remain
• Purpose:
- Increase RBC mass and oxygen-carrying capacity
- Assists the body to rid carbon dioxide and other waste products
• Indications:
- Symptomatic and chronic anemia
- Blood loss due to injury or surgery
12. CRYOPRECIPITATE
•CRYOPRECIPITATE IS A SUPERNATANT PRECIPITATE OF
FRESH FROZEN PLASMA AND IS RICH IN FACTOR VIII AND
FIBRINOGEN.
•IT IS STORED AT -30 DEGREES CENTIGRATE WITH A 2 YEARS
SHELF
LIFE.
•INDICATED IN LOW FIBRINOGEN STATES (<1g/L) OR IN
CASES OF
FACTOR VIII DEFICIENCY (HAEMOPHILIA-A), VON
WILLEBRAND’S DISEASE AND AS A SOURCE OF
FIBRINOGEN IN DISSEMINATED INTRAVASCULAR
COAGULATION.
•POOLED UNITS CONTAINING 3-6 gms FIBRINOGEN IN 200-
500 ml RAISES THE FIBRINOGEN LEVEL BY APPROX. 1g/L.
•MUST BE INFUSED WITHIN 6 HOURS.
13.
14. GENERAL INSTRUCTIONS FOR GIVING
BLOOD TRANSFUSIONS
Selection of the donor
•Donor shall be free of diseases of heart ,kidneys,lungs,liver
etc.
•There should not be any history of cancer, jaundice,
hepatitis, tuberculosis ,allergies
•They should be physically healthy, and should be between
18 and 65 years of age with in average height and weight.
•Donors must have normal temperature ,pulse and blood
pressure.
•They must not have been pregnant with in the last 6months.
15. CONT.......
•Before the blood is transfused,the donors blood must
be cross matched with the recipients blood.
•Explain the procedure to the donor and reassure
him/her to win his confidence and co-operation.explain
the sequence of the procedure and tell him how we can
co-operate in the procedure.
•Blood should not be collected empty stomach .the donor
should not be dehydrated. following the donation of
blood the donor should be given a sweetened drink and
asked to take rest for one to two hr to prevent fainting
attacks.
16. CONT.......
-The donor is asked to complete a questionnaire
detailing any history of infectious diseases and other
medical issues before they are allowed to donate blood
for transfusion.
- The donor’s hemoglobin level is checked.
- Once collected, the blood is examined and screened for
possible infectious agents such as HIV and hepatitis.
17. CONT.......
The blood is transfused through tubing that is connected
to a needle or catheter supplying the vein.
The amount of blood transfused depends on the
individual patient’s needs.
During blood transfusion, vital signs such as temperature,
heart rate, and blood pressure are carefully monitored.
Some patients may get a sudden fever during or within
24 hours of the transfusion, which may be relieved with
acetaminophen or paracetamol. This fever is a common
reaction to the white blood cells present in donated blood.
18.
19.
20.
21. Nursing Implications
Before transfusion:
• Check physician’s orders
• Review hospital policy
• Ensure informed and written consent is provided
• Check laboratory values
• Understand the indications and rationale
• Verification procedure occurs with
two nurses
22. Nursing Implications (Con’t)
Before transfusion (con’t):
• Compatibility of blood type and Rh factor
• Inspect the blood product for discolouration, clots, leaking, or
presence of bubbles
• Check the unit number on the unit of blood and on the form
• Check the expiration date and time on unit of blood
• Ask client to state first and last name
• Check patient’s identification number on wristband and
record
23.
24.
25.
26.
27.
28. Nursing Implications Con’t
During the transfusion:
• Monitor vital signs closely during the blood
transfusion
• Inspect condition of IV site
• Observe for signs and symptoms of a
reaction
29. . RECORD:
•TIME WHEN THE TRANSFUSION IS STARTED.
•TIME WHEN THE TRANSFUSION IN COMPLETED.
•VOLUME AND TYPE OF ALL PRODUCTS
TRANSFUSED.
•BLOOD PACK NUMBERS.
•ANY ADVERSE EFFECTS.
SEVERE REACTIONS MOST COMMONLY PRESENT IN
THE FIRST 15-30 MINUTES OF A TRANSFUSION
THEREFORE THEY SHOULD BE CLOSELY MONITORED
DURING THIS TIME.
-IF THE PATIENT APPEARS TO BE EXPERIENCING AN
ADVERSE REACTION THE TRANSFUSION MUST BE
IMMEDIATELY STOPPED AND URGENT MEDICAL
ASSISTANCE SHOULD BE SEEKED FOR.
30. Nursing Implications Con’t
After the transfusion:
• Dispose of materials/equipment
• Observe patient for clinical
improvements
• Assess the laboratory values for
effectiveness of transfusion
31.
32.
33. Nursing Implications in a Reaction
• Stop transfusion
• Remove tubing that contains blood product
• Infuse with 0.9% normal saline
• Monitor vital signs
• Notify physician
• Notify blood bank and return blood component
• Administer medication depending on type of
reaction
– Epinephrine, antihistamines, antibiotics, antipyretics,
analgesics, diuretics, corticosteroids
Editor's Notes
- helps to stop bleeding - including internal bleeding
