Blood Transfusion by Nurses In Formations 1215736980991777 9

8/3/2019 Blood Transfusion by Nurses In Formations 1215736980991777 9

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IV Therapy

TrainingNursing Procedure


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C c to e t Master text sty esSecond level Third level Fourth level

Fifth level


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Forensic Science

Blood Basics

T. Trimpe 2006 http://sciencespot.net/


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What makes up our blood?

RED BLOOD CELLS (Erythrocytes) The most abundant cells

in our blood; they are produced in the bone marrow and contain aprotein called hemoglobin that carries oxygen to our cells.

WHITE BLOOD CELLS (Leukocytes) They are part of theimmune system and destroy infectious agents called pathogens.

PLASMA This is the yellowish liquid portion of blood thatcontains electrolytes, nutrients and vitamins, hormones, clottingfactors, and proteins such as antibodies to fight infection.

PLATELETS (Thrombocytes) The clotting factors that arecarried in the plasma; they clot together in a process called

coagulation to seal a wound and prevent a loss of blood.


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Blood Facts

The average adult has about FIVE liters of blood inside oftheir body, which makes up 7-8% of their body weight.

Blood is living tissue that carries oxygen and nutrients toall parts of the body, and carries carbon dioxide and other

waste products back to the lungs, kidneys and liver fordisposal. It also fights against infection and helps healwounds, so we can stay healthy.

There are about one billion red blood cells in two to three

drops of blood. For every 600 red blood cells, there areabout 40 platelets and one white cell.

http://www.bloodbankofalaska.org/about_blood/index.html


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Genetics of Blood Types

Your blood type is established before you are BORN, by

specific GENES inherited from your parents.

You inherit one gene from yourMOTHERand one fromyourFATHER.

These genes determine your blood type by causing proteins called AGGLUTINOGENS to exist on the

surface of all of your red blood cells.


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What are blood types?

http://learn.genetics.utah.edu/units/basics/blood/types.cfm

There are 3 alleles or genes for bloodtype: A, B, & O. Since we have 2 genes,there are 6 possible combinations.

Blood Types

AA or AO =Type A

BB or BO =Type B

OO = Type OAB = Type AB


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How common is your blood type?

46.1%

38.8%

11.1%

3.9%


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Blood Transfusions

A blood transfusion is a procedure in which blood is given to a

patient through an intravenous (IV) line in one of the blood vessels.Blood transfusions are done to replace blood lost during surgery or aserious injury. A transfusion also may be done if a persons bodycan't make blood properly because of an illness.

A B

O

AB

Who can give you blood?

People with TYPE O bloodare called Universal Donors,

because they can give blood toany blood type.

People with TYPE AB bloodare called UniversalRecipients, because they canreceive any blood type.

Universal

Donor

UniversalRecipient


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Rh Factors

Scientists sometimes study Rhesus monkeys to

learn more about the human anatomy because thereare certain similarities between the two species.While studying Rhesus monkeys, a certain bloodprotein was discovered. This protein is also presentin the blood of some people. Other people, however,do not have the protein.

The presence of the protein, or lack of it, is referredto as the Rh (forRhesus) factor.

If your blood does contain the protein, your blood issaid to be Rh positive (Rh+). If your blood does not

contain the protein, your blood is said to be Rhnegative (Rh-).

A+ A-

B+ B-AB+ AB-O+ O-

http://www.fi.edu/biosci/blood/rh.html


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Blood Evidence

Blood samples Can be analyzed to determine blood

type and DNA, which can be matched to possiblesuspects.

Blood droplets Can be analyzed to give clues to thelocation of a crime, movement of a victim, and type ofweapon.

Blood spatter Can be analyzed to determine patternsthat give investigators clues to how a crime mighthavehappened.


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Microscopic

ViewsBird Blood

Cat Blood

Dog Blood

Fish Blood

Frog Blood

Snake BloodHuman Blood

Horse Blood


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Blood

TransfusionNursing Procedure


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*Whole blood transfusion replenishes thecirculatories:

Volume

Oxygen-carrying capacity

*Packed Red Blood Cells (RBCs) restores:

Oxygen-carrying capacity

Both treat decreased hemoglobin and hematocrit.


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Two nurses must identify the:

1. Patient2. Blood products

before administering a transfusion (toprevent errors & potentially fatalreaction)


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If a patient is a Jehovas Witness, atransfusion requires special writtenpermission.


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Equipments needed

1. Bloodrecipient set(filter & tubing

with dripchamber forblood, orcombined set)


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Equipments needed

2. I.V. pole

3. Gloves

4. Gown5. Face Shield


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Equipments needed

6. Multi-lead tubing


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Equipments needed

7. Whole blood or packed RBCs


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Equipments needed

8. 250 ml of Normal Saline Solution


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Equipments needed

9. Venipuncture equipment, ifnecessary (should include 20G orlarger catheter)


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Equipments needed

10. optional: ice bag, warmcompresses


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Getting Ready

Avoid obtaining either whole blood orpacked RBCs until youre ready tobegin the transfusion

Prepare the equipment when youreready to start the infusion.


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The Procedure

Explain the procedure to the patient

Make sure an informed consent hasbeen signed

Record baseline vital signs


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The Procedure

Obtain whole blood orpacked RBCs from theblood bank within 30

minutes of the transfusionstart time.


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The Procedure

Check theexpiration date onthe blood bag, &observe forabnormal color, RBCclumping, gasbubbles, &extraneousmaterial. Returnoutdated orabnormal blood tothe blood bank.


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The Procedure

Compare the name & number on thepatients wristband with those on the bloodbag label.


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The Procedure

Check the blood bagidentificationnumber, ABO bloodgroup, and Rh

compatibility.

Also, compare the

patients blood bankidentificationnumber, if present,with the number on

the blood bag.


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The Procedure

Identification of blood & bloodproducts is performed at the patientsbedside by two licensed profesionals,according to the facilitys policy.


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The Procedure

Wash your hands.Put on gloves, a gown, & a face shield.


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Remove IV administration set and fluid frompackaging


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Remove the cover from the selectedspike and the cover from thebottle/bag of fluid.


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The Procedure

Then insert the spike of the line youreusing for the normal saline solutioninto the bag of saline solution

aseptically.


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When fluid drips out of the end of the

distal tubing turn off the infusion rateclamp.


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The Procedure

Using a Y-type set, close all the clampson the set.


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The Procedure

Next, open the port on the blood bag &insert the other spike.


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The Procedure

Hang the bags onthe I.V. pole,


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The Procedure

open the clamp on the line of salinesolution,


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The Procedure


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The ProcedureIf the patient doesnt have an I.V. line

in place, perform venipuncture, using a20G or larger-diameter catheter.


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The Procedure

Avoid using an existing line if theneedle or catheter lumen is smallerthan 20G.

Ventral venous access devices alsomay be used for transfusion therapy.


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The Procedure

If youre administering whole blood,gently invert the bag several times tomix the cells.


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The Procedure

Attach the prepared bloodadministration set to the venipuncturedevice, & flush it with normal saline

solution.


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The Procedure

Then close the clamp to the salinesolution, & open the clamp betweenthe blood bag & the patient.


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The Procedure

Adjust the flowclamp closest tothe patient to

deliver the bloodat the calculateddrip rate.


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The Procedure

Remain with the patient, & watch forthe signs of a tranfusion reaction, suchas fever, chills, & wheezing.


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The Procedure

Infuse saline solution at a moderatelyslow infusion rate, & notify the doctorat once.

h d


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The Procedure

If no signs of a reaction appear within15 minutes, youll need to adjust theflow clamp to the ordered infusion

rate.

h d


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The Procedure

A unit of RBCs may be given over 1-4hours as ordered.

Th P d


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The Procedure

After completing thetransfusion, youllneed to put on

gloves & remove &discard the usedtransfusion

equipment.

Th P d


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The Procedure

Then remember to reconnect theoriginal I.V. fluid, if necessary, ordisconnect the I.V. infusion.

Th P d


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The Procedure

Return the empty blood bag to theblood bank, & discard the tubing &filter.

Th P d


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The Procedure

Record the patients vital signs.

P ti P i t


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Practice Pointers

Although some microaggregatefilters can be used for up to 10 units ofblood, always replace the filter &

tubing if more than 1 hour elapsesbetween transfusions.

P ti P i t


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Practice Pointers

When administering multiple units ofblood, use blood warmer to avoidhypothermia.

P ti P i t


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Practice Pointers

For rapid blood replacement, knowthat you may need to use a pressurebag.

P ti P i t


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Practice Pointers

If youre administering packed RBCswith Y-type set, you can add salinesolution to the bag to dilute the cells

by closing the clamp between thepatient & the drip chamber & openingthe clamp from the blood

P ti P i t


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Practice Pointers

Then lower the blood bag below thesaline solution container & let 30-50mlof saline solution flow into the packed

cells.

P ti P i t


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Practice Pointers

Finally, close the clamp to the bloodbag, rehang the bag, rotate it gently tomix the cells & saline container

D ti Bl d


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Documenting BloodTransfusion

In your notes, record:

Date & time of the transfusion.

Type & amount of transfusion product.

Patients vital signs.

Your check of all identification data.

Transfusion reaction & nursing actionstaken.

N rses Informations


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Nurses Informations

Documents

Blood Transfusion by Nurses In Formations 1215736980991777 9