102- Blood Transfusions Flashcards
What test determines Rh status?
Coombs testing
Type/cross match valid for how long?
72 hours
Only solutions compatible w transfusion
NS
3 things verify before administration
Blood components=ones ordered, blood delivered=compatible w blood type, and right patient
Times for transfusion
Only have 4 hours to transfuse! Must start within 30 mins of blood leaving bank
How to prime blood tubing
With normal saline Bc isotonic so won’t compete with plasma (must prime Bc air+blood=coagulation)
How much infuse in first 15 mins
10-25ml don’t leave
Acute IV hemolysis
Most serious reaction, within first few mins, destruction RBC
Acute IV hemolysis s/s
Low back/flank pain, fever/chills, dyspnea, tachycardia, tachypnea, headache, hypotension, hemogloinemia, oliguria, anxiety, chest pain/tightness, bronchospasm, circulatory shock, death
Febrile, non-hemolytic s/s
Most common Bc leukocyte antibodies in recipient react with donor WBC
Sudden shaking chills (rigors), fever >1 degree from base, headache, flushing, muscle pain, itching, urticaria (hives), anxiety
Clinical management of non-hemolytic fever
Stop trans, antipyretics (not aspirin), DONT RESTART transfusion, monitor temp
Urticarial/mild allergic
Antibodies against donor plasma proteins –> rash, puritis, itching, urticaria (hives), flushing
Stop trans, MD, treat symptoms, monitor, if symptoms resolve restart UNLESS fever, pulmonary symptoms or hypotension then don’t restart
Anaphylactic
NOT caused by RBC incompatibility, first 5-15 mins
Anxiety, urticaria, dyspnea, wheezing/cyanosis, hypotension, circulatory shock, cardiac arrest
Never restart
Circulatory overload s/s
Cough, dyspnea, Orthopnea, crackers, tachycardia, HYPERtension, distended neck veins, headache
Oxygen, diuretics
Sepsis s/s
High fever, chills, hypotension, abdominal cramps, renal failure, vomit, diarrhea, oliguria, disseminated IV coagulation
