Blood Service

Question 1

How many New Zealanders will need a blood transfusion during their lifetime

Answer 1

80%

Question 2

How many New Zealanders donate blood?

Answer 2

4%

Question 3

How long does it take to donate 470mL whole blood, and what percentage is it?

Answer 3

15 minutes

> > 55% plasma (260mL)
1% platelets/white cells (5mL)
44% red cells (205mL)

Question 4

How many units of blood is administered?

Answer 4

476 donated units administered

Question 5

Who needs blood?

Answer 5

Unwell Child & Aged Care
Long COVID
Trauma Cases
Elective Surgery
Cancer Patients
Emergency Surgery
Congenital Conditions
Solid Organ & Marrow Transplant
Chronic Illness
Obstetric Bleeds
Haemolytic Disease of the Newborn

Question 6

Whats the Maximum Average Blood Volumes for a premature neonate?

Answer 6

95ml/kg

Question 7

Whats the Maximum Average Blood Volumes for a Full-term neonate?

Answer 7

85mL/kg

Question 8

Whats the Maximum Average Blood Volumes for a Infant?

Answer 8

80mL/kg

Question 9

Whats the Maximum Average Blood Volumes for an adult?

Answer 9

Average 70mL/kg
Men 75mL/kg
women 65mL/kg

Question 10

What are the 45% formed elements (RBC) in blood

Answer 10

Cells (erythrocytes (RBC), leucocytes (WBC) and cell fragments (thrombocytes)

Question 11

What are the 55% blood plasma in blood

Answer 11

liquid containing dissolved substances

Question 12

What is the main purpose of erythrocytes?

Answer 12

• Primary purpose is the transportation of oxygen to cells and removal of some CO2
• Oxygen carrying capacity depends on level of haemoglobin
• Ref range: 130-175g/L (Awanui Dunedin)
• Male: 140-165g/L
• Female: 120-150g/L

Question 13

What is the main purpose of Leucocytes?

Answer 13

Two types:
* granulocytes (neutrophil, eosinophil, basophil)

• agranulocytes (lymphocytes, monocytes)

Question 14

What is the main purpose of Thrombocytes (Platelets)?

Answer 14

• Not strictly a cell but a fragment of a megakaryocyte
• Production stimulated by hormone thrombopoietin
• Primary purpose is haemostasis (the plug) to prevent and stop bleeding
• Ref range 150-400
• Lifespan of 5 - 10 days

Question 15

Before giving blood

Answer 15

You need
* Valid group & screen
* Prescription
* Informed Consent
* Patent vascular access
* Equipment
* Baseline Obs
* Documentation
* Two certified staff

Check radial pulse, do not want to give blood to someone with AF

Question 16

Why do you need to test someones blood before transfusion?

Answer 16

To ensure that the donated blood is compatible with the patient’s blood

• Blood type
• Cross-matching (ABO and Rh D antigens)
• Patient identification
• SCREEN: For red cell antibodies

(pink tube)

Question 17

What must blood samples require

Answer 17

Samples require:
* patient identifiers (first and last name, DOB, NHI)

• Collector completed the date/time/sign

Question 18

What is the final must do after texting someone blood for transfusion?

Answer 18

Must sign the mandatory declaration stating they
- Collected the sample
- Confirmed identity
- Labeled and sampled the tubes

Question 19

What does no group and screen
mean?

Answer 19

A valid group and screen enables the release of crossmatched red cells

Only O neg blood

Question 20

What must happen before infusion?

Answer 20

Informed Consent
Prescribed
Equipment gathered

Question 21

Whats in a blood transfusion set?

Answer 21

Dedicated Blood Infusion Set

*includes 170 – 260 micron filter

*CRITICAL: ensure the set is not vented

New (un-used) set at start, down at end.

Maximum dwell time: 12 hourly
* Average: 2-4 units
* & Rapid: 8-10 units
Administer platelets via a fresh set .

Question 22

What do Blood Filters (= sieve) do?

Answer 22

Enable good stuff to go through
 Red cells
Platelets
FFP
Cryo
Granulocytes

While trapping waste

Question 23

What to prime the line with?

Answer 23

Prime with normal saline
* to keep vein open
* preserve cannula integrity
*Do NOT vent
If you elect to prime the set with blood,
* it cannot occur until after the bedside checks

Question 24

When do you need to take obs before and infusion

Answer 24

Baseline Observations up to 60 minutes prior

TPR/BP

Question 25

What do you do when your ready to request first red cell unit?

Answer 25

Send the green form

Question 26

What to check before administering blood?

Answer 26

Bag to Tag
Volume
Unit number
Expiry date
Blood Group

Question 27

What are the Timeframes to Administer blood?

Answer 27

4 hours from issue (4-hour rule)
* Red Cells, FFP, Cryoprecipitate

4 hours from spiking the bottle
* Intragam P, Privigen, Albumin (use vented sets)

3 hours from reconstitution
* Coagulation factors: Biostate,
Prothrombinex-VF, Thrombotrol (rate = 3mL/min (180mL/hour) via syringe infusion pump - Graseby 3400)

1 hour from issue
* Platelets

Question 28

How often must you monitor patient with a blood transfusion?

Answer 28

Stay with them for first 15, and take obs
Q 30 min TPR
Q 1 hour BP
TPR/BP at completion

Question 29

Do you do overnight transfusions?

Answer 29

Overnight transfusions…No!

• Routine transfusions till 22oohr
• After 22.00hours? sleep-time
• Unless unstable / emergency transfusions

Question 30

What are symptoms of a transuion reaction?

Answer 30

Rash
Angioedema
Urticaria
Anxiety
Severe Apprehension
Nausea
Vomiting
Diarrhoea
Pain: Loin, chest, IV site…
Dyspnoea
Respiratory
Distress
Hypoxia
Abnormal Bleeding
Red/Black Urine
Fevers
Chills
Rigors
Changes in
Vital Signs