Blood Administration Flashcards
explain consent and when consent doesn’t need to be given
When the person understands and agrees
required by standards and regulations
• no consent needed if the transfusion is required to preserve life or continuing health
• Patient is unable to consent and no substitute decision maker is available
• no evidence of prior wishes to refuse transfusion known for personal or religious reasons
all blood orders must include?
first and last name and at least 1 urn type of blood product number of units or amount rate of infusion special requirements premedication, if required Group type and crossmatch
what is the best time for blood transfusions if they are non-urgent?
the early shift
before picking up the blood what needs to happen?
ensure IV patency
verify consent
administer any premeds
arrange for pickup and delivery
How should blood be checked?
be at the bedside 2 qualifyed individuals need to check check for clots, strange colour, leaks Check compatible blood group Verify order and consent must be started immediately after being checked label must remain attached to blood unit throughout transfusion place documentation in patients chart
What are the steps for checking blood?
- check armband
- check that patients name and urn match on armband and blood bag
- check blood unit number and donor blood group matches
before starting the blood what needs to happen?
get baseline vital signs
after starting the blood what needs to happen?
for first 15 mins
- start at slow rate and monitor closely
after the first 15 minutes
- reassess vital signs and increase blood flow if no reaction observed
what do we need to do when completing the trasfusion?
flush the line
disconnect the tubing
bag must be stopped after 4 hours from removal from storage
dispose of in biohazard container or return to blood collection if required
what are the 3 different components of blood products?
red blood cells
plasma
platlets
what are the major uses of red blood cells?
bleeding
anaemic non-bleeding
Low HB
How are red blood cells stored and for how long can they be stored?
2-6 degrees C in approved fridge only
Up to 42 days
what are the major uses of plasma and how many different products can plasma make?
16 different products
liver disease coagulopathy
massive transfusions
What are some of the different plasma products?
clinical plasma intravenous immunoglobin hepatitis B immunisation hepatitis A immunisation cryoprecipitate albumin tetanus immunisation Zoster immunisation
How do you store plasma, and for how long until it expires?
frozen - stored for 1 year
once thawed stored at 1-6 degrees C
expires after 24 hours or 5 days
What are some reactions to transfusions?
usually occur within 24 hours • Fever • Shaking chills or rigour without fever • hives or rash, itchiness, swelling • dyspnea, shortness of breath or wheezing • hypotension or hypertension • red urine, diffuse bleeding or oozing • lumbar/lower back pain, anxiety, pain at the IV site • nausea and vomiting • headache
what management should you do if there is a reaction?
- stop transfusion immediately
- maintain IV access but do not flush the blood tubing
- check vital signs
- verify ID matches fluid label
- notify doctor but remain with patient
- notify nursing team leader
- notify blood bank as per hospital policy
- treat symptoms as ordered by doctor
when restarting a transfusion what needs to happen?
the person needed the blood in the first place
only restart if very minor reaction
consult for order to restart
medicate patient as ordered
proceed with more frequent observations
what happens in a reaction investigation?
blood bag and tubing sent to be investigated
What are some complications?
Acute intravascular hemolysis
Disseminated Intravascular Coagulation
What happens in acute intravascular haemolysis?
Symptoms may include chills, rigors, dyspnoea, chest and/or flank pain, discomfort at infusion site, sense of dread, abnormal bleeding and may progress rapidly to shock.
What happens in Disseminated Intravascular Coagulation and what are some symptoms?
• The blood’s platelets and clotting factors to become depleted, excessive bleeding (haemorrhage) occurs throughout the body.
• The severity of bleeding can range from small red dots and bruises under the skin to heavy bleeding.
• Symptoms of organ damage caused by excessive blood clotting may include:
shortness of breath from lung damage, low urine output from kidney damage, or stroke from damage to the brain.
What gauge IV access needs to be used?
16-18 gauge for rapid transfusion for adults
for routine 20-22 gauge for adults
What are the major uses of Platelets?
to control or prevent bleeding in patients with
• low platelet counts
• congenital platelet dysfunction
• platelets not functioning due to medication effects
How are platelets stored?
20-24 degrees C or on an agitator to prevent clumping
expire in 5 days
what proportion of blood volume do the following constituents provide?
- plasma
- red blood cells
- white blood cells and platelets
plasma - 55
RBC - 45
white blood cells and platelets - 10
How long can reaction symptoms occur after blood has finished?
6 hours
What is clinical plasma (ffP)used for?
major bleeding
What is cryoprecipate used for?
clotting
What is intravenous immunoglobulin (INtragam) used for?
replaces antibodies
used in the treatment of some immune, blood and neurological disorders.
What is albumin used for?
For treatment of shock due to blood loss, during heart-lung bypass surgery and plasma exchange
