Blood Transfuion

Question 1

Transfusion reaction s/s

Answer 1

• fever
• chills
• resp distress
• low back pain
• pain at IV site
• low risk of disease contract from blood

Question 2

Transfusion steps

Answer 2

• obtain blood
• 2 pt identify
• double check blood with RN
• monitor @ bedside for 15 min

Question 3

Transfusion procedure

Answer 3

• start within 30 min once obtained
• run blood within 4 hrs
• change tubing after 2 trans or 4 hours
• first 15 mins sun blood no faster than 5mL/min
• immediately stop trans if sus reaction

Question 4

Rule of thumb for fluid overload

Answer 4

-1/2 the volume over 2x the time

Question 5

Transfusing platelets

Answer 5

• 22 gauge or larger
• one unit can be given over 30-90 mins
• still monitor for reaction

Question 6

Febrile non-hemolytic reaction (non life threatening*)

Answer 6

• frequent with multiple trans
• s/s: chills, muscle stiffness, fever increased 1 Celsius
• starts 2 hr after start of trans
• diminish or prevent by leukocyte filter or leukocyte reduce blood
• pre meds can give but mask s/s of severe reaction

Question 7

Acute hemolytic reaction (life threatening*)

Answer 7

• incompatibility of blood*
• occur with 10mL trans
• s/s: chills, fever, low back pain, nausea, chest tight, dyspnea, anxiety
• can result in hypotension, bronchospasm, vascular collapse

Question 8

Delayed hemolytic reaction

Answer 8

• occur within 14 days
• mild reaction
• fever, anemia, increased bilirubin, jaundice, decreased or absent haptoglobin

Question 9

Transfusion related acute lung injury (TRALI)

Answer 9

• occur within 6 hr of trans, usually 2 hr
• abrupt in onset
• s/s: acute SOB, hypoxia, hypoxemia, R/O cardiac cause
• aggressive support: O2, rapid intubation, fluid management (no lasix*)
• most common cause of transfusion related death*

Question 10

Long term complications

Answer 10

• seen in multiple PRBC transfusions: MSD, thalassemia, aplastic anemia, sickle cell
• greater risk sensitivity to donor antigen
• iron overload leads to organ dmg

Question 11

Alternatives to blood transfusion

Answer 11

• growth factors
• erythroprotein
• granulocyte colony—stim factor
• granulocyte—macrophage colony stim factor
• thrombopoietin