Blood and Blood Product Transfusions

Question 1

What are the 4 different ABO groups?

Answer 1

A
B
O
AB

Question 2

What is the Rh System?

Answer 2

• The Rh factor is based on the D antigen which is a protein found on the surface of RBC’s.

Question 3

What is Rh “-ve”?

Answer 3

D antigen is absent

Question 4

What is Rh “+ve”?

Answer 4

D antigen is present`

Question 5

What are the different types of blood products?

Answer 5

• Whole blood - rarely used
• Red blood cells: commonly used
• Platelets
• Fresh frozen plasma (FFP)
• Albumin

Question 6

What is a cross match?

Answer 6

Involves either a serological cross match of the patient’s plasma versus donor red cells or, in some hospitals, an electronic cross match, where the blood bank computer performs the last compatibility check. Once pre-transfusion testing is completed blood can be issued to the ward or operating theatre

Question 7

What are the important parts of a cross match?

Answer 7

• It detects incompatibility between a patient and donor blood chosen for transfusion
• The units compatible are labelled specifically for the patient
• The blood bank holds the units and releases them immediately upon request

Question 8

What is the management processes of blood transfusion before the blood arrives?

Answer 8

• Know why the patient requires a transfusion
• Prepare and talk to your patient
• Ensure that the patient has a valid sample for “group and screen” in the Blood Bank
• Ensure written, informed consent has been obtained
• Ensure blood is prescribed and prescription signed by the Medical Practitioner
• Prepare your equipment
• IV line primed with 0.9%NaCL only
• Min 20G leur, 18G preferable
• Send for the blood (using appropriate forms and systems)

Question 9

What is the process of managing blood transfusions when the blood arrives?

Answer 9

• Take the unit, prescription & consent to the bedside, and check all of this with another RN
• Ask the patient identify themselves - full name and DOB while checking the patients wristband and details on swing label on the blood bag
• Both nurses check the unit number, component, unit group that has been provided by the blood bank with details on swing label on the blood bag
• Check expiry date on unit
• Spike the unit and prime the line - always use a line with a 170-220 micron filter or add a 170-200 micron filter onto the giving set
• Set up line - may use an infusion pump
• Have 30 minutes in which to begin the infusion

Question 10

What are the observations needed for blood transfusions?

Answer 10

• Baseline temp, pulse, respiration & manual blood pressure
• Remain with your patient for the first 15 mins of the transfusion
• Repeat all vital signs within 15 min of commencement
• Depending on patients condition & hospital policy, vital signs are monitored and recorded every 30 mins, 1 hrly or 2 hrly
• Always take and document observations at the end of every unit
• Read and be familiar with the hospital blood policies prior to transfusing the patient

Question 11

What are the adverse effects of blood transfusions?

Answer 11

• Febrile Non-Haemolytic Transfusion Reaction
• Allergic reaction
• Anaphylatic reaction
• Hypotensive reaction
• Acute Haemolytic Transfusion Reaction
• Bacterial sepsis
• T.A.C.O. - Transfusion Associated Circulatory Overload