Blood products Flashcards
BLOOD ADMINISTRATION: TYPING
-blood is grouped according to the presence or absence of specific antigen
RH (RHESUS) FACTOR
- the presence or absence of the RH antigen “D” on the surface of the RBC’s determine the classification of RH- positive (85%) or negative
- if a person is RH negative they can only receive negative blood
- if a person is RH positive they can receive Rh positive or negative blood
BLOOD CROSSMATCHING
- done to decrease the potential for reaction
- mixing the recipient’s serum with the donor’s RBC followed by the addition of a direct coomb’s test
BLOOD TRANSFUSIONS
- O negative is the universal donor
- AB+ is the universal recipient
FIVE TYPES OF TRANSFUSABLE BLOOD PRODUCTS
- whole blood
- red blood cells
- platelets
- plasma
- cryoprecipitate
USE OF DONATED BLOOD PRODUCTS POST-COLLECTION
RBC’s - within 42 days
PLT’s - within 5 days
plasma and cryo- stored frozen and may be used up to one year
WHOLE BLOOD
- replenishes both volume and oxygen carrying capacity
- emergency and acute trauma
- 500ml of volume per unit
PRBC’S
- prevents circulatory overload
- 80% of the plasma has been removed
- hemoglobin <10g/dl
- hematocrit <10g/dl
- each unit should increase the hematocrit about 3%
- one unit over 2-4 hours
PLATELETS
-given when platelets are less the 20,000 or with active bleeding
PLASMA
-contains a lot of clotting factors and provides volume (250ml/unit) or INR > 1.7
ALBUMIN
-100ml acts like 500ml of plasma in provding volume into intravascular space
CRYOPRECIPITATE
given when fibrinogen level less than or equal to 100 milligrams/dl
AUTOLOGOUS BLOOD
- safest way to receive a transfusion
- pre operative donation
- donation at least 3 days prior to surgery
- can not if hemoglobin is less than 11g/dl
BLOOD ADMINISTRATION STEPS
- check the orders and consent
- “no blood” status
- check labs
- blood bank administration band
- assess vitals: temp
- patient teaching
- check your IV site condition and patency
- IV tubing set up NS only
- start blood transfusion within 30 min of receiving it
- bedside check with a licensed personnel
IV SITE
- check the gauge of the catheter
- what the site looks like
- flush
- if a new central line make sure that it has been cleared by x-ray
- no medication can run with the blood only normal saline
PRE-MEDICATION
history of an allergic reaction may be ordered to receive:
- Tylenol
- Benadryl
CHECKING LABEL
- patients full name
- medical record number
- blood bank armband number
- unit number
- blood component type
- ABO/RH type compatibility
- expiration date
- signature by two licensed
BLOOD ADMINISTRATION
- put on protective gear
- blood tubing with filter and NS
- flush line with saline
- no medication in line
- start infusion no faster than 50ml over 15 min
- remain with the patient over the 1st 15 min
- administer one unit over 2-4hrs
- check vitals and observe patient per protocol
- blood bags and tubing go into red bag trash
BLOOD ADMINISTRATION
- warmer -hypothermia
- blood filters good for up to 2 units or 6 hours
- new IV pumps wont crush RBC in blood
COMPLICATIONS
- circulatory overload
- hypothermia
- citrate toxicity
- hypocalcemia
- hyperkalemia
TRANSFUSION REACTION : ALLERGIC
- flushing
- itching
- rash
- wheezing/ stridor
- hives
- laryngeal edema
- anaphylaxis
- tachycardia
TRANSFUSION REACTION : FEBRILE
- chills
- fever
- headache
- palpitations
- cough
- chest tightness
- increased heart rate
- muscle pain
TRANSFUSION REACTION: HEMOLYTIC
- chills fever
- chest pain
- flushing
- diaphoresis
- increased heart rate
- flank pain
- hemoglobinuria
- MAY OCCUR UP TO 14DAYS POST INFUSION
TRANSFUSION REACTION: SEPSIS
- sudden onset chills
- very high fevers
- abdominal cramping
- diarrhea
- hypotension
- shock
- signs of renal failure
TRANSFUSION REACTION
STOP INFUSION
- take vitals q 15 min
- NS at KVO
- notify MD
- notify blood bank
- collect blood and urine samples
- follow MD instructions and facility protocols
- place on strict I and O
- Do not discard blood or tubing
- documentation
