Blood Transfusion Flashcards
Blood group
- Red blood cells are covered by proteins that make up a personโs blood group. The four major blood groups are O, A, B, and AB.
- About 85 percent of the people in the United States have a substance on their red blood cells called the โRh factor.โ These people are โRh positive.โ The remaining 15 percent of Americans are called โโRh negativeโ because they do not have the Rh factor.
โ This is why a personโs blood may be referred to as โA positiveโ (group A, Rh positive) or โO negativeโ (group O, Rh negative).
Whole blood:
- Blood with all blood components intact
- contains all blood components: RBCs, WBCs, Platelets, Plasma, Clotting factors, Immunoglobulins
- transfused 24 hours after collection due to degradation of clotting factors
Whole blood Indication:
- (rarely used) to rapidly restore blood volume and oxygen-carrying capability of blood, as in cases of blood loss from hemorrhage
Whole blood Administration:
Give whole blood or packed RBCs through a Y-type I.V. set with a 170-micron filter unless a 20- to 40- micron filter (for microaggregates from degenerating platelets and fibrin strands) is ordered.
Red blood cells (RBCs):
- Whole blood with 80% of plasma removed & platelets removed; volume usually 250 mL
- contain hemoglobin
Red blood cells (RBCs) Indication:
- to maintain or boost oxygen-carrying capability of the blood, as in cases of:
โ blood loss from GI bleeding or surgery
โ RBC destruction from chemotherapy - contain hemoglobin
Red blood cells (RBCs) Administration:
Give whole blood or packed RBCs through a Y-type I.V. set with a 170-micron filter unless a 20- to 40- micron filter (for microaggregates from degenerating platelets and fibrin strands) is ordered.
Leukocyte-poor RBCs:
Same as RBCs but with about 95% of leukocytes removed; volume about 200 mL
Leukocyte-poor RBCs Indication:
for treatment of febrile nonhemolytic transfusion reaction caused by WBC antigens reacting with a patientโs WBC antibodies or platelets
leukocyte-poor RBCs Administration:
Administer leukocyte-poor RBCs with a straight-line or Y-type I.V. set to infuse blood over 1 1/2 to 4 hours. Use a 40-micron filter suitable for hard-spun leukocyte-poor RBCs.
Hemoglobin
Each unit of whole blood or RBCs contains enough hemoglobin (Hb) to raise the Hb level in an average- size adult by 1 g/dL (about 3%)
White blood cells (WBCs, also called leukocytes):
Whole blood with all RBCs and about 80% of plasma removed; volume usually 150 mL
White blood cells (WBCs, also called leukocytes) Indication:
- to treat sepsis that is unresponsive to antibiotics (especially if the patient has blood cultures positive for sepsis or a persistent fever that exceeds 101ยฐ F [38.3ยฐ C] and granulocytopenia [granulocyte count usually less than 500/ฮผL])
- When administering WBCs, premedicate with diphenhydramine (Benadryl), as prescribed.
WBC Administration:
Administer WBCs using a straight-line I.V. set with a standard in-line blood filter to provide 1 unit daily for 5 days or until the infection resolves.
- Because a WBC infusion induces fever and chills, administer an antipyretic if fever occurs. Donโt discontinue the transfusion; instead, reduce the flow rate, as ordered, for patient comfort.
- Agitate the WBC container to prevent settling, thus preventing the delivery of a bolus infusion of WBCs
Platelets
Fragments of large bone marrow cells (called megakaryocytes) that help with clotting; volume 35 to 50 mL/unit
Platelets Indication:
to treat thrombocytopenia caused by decreased platelet production, increased platelet destruction, or massive transfusion of stored blood; to treat acute leukemia and marrow aplasia; and to improve platelet count preoperatively in a patient whose count is 100,000/ฮผL or less
Platelet Administration:
- Platelets require a component drip administration set to infuse 100 mL over 15 minutes. As prescribed, premedicate with an antipyretic and an antihistamine if the patientโs history includes a platelet transfusion reaction. If the patient has a fever before administration, notify the practitioner for probable delay of the transfusion.
- Prepare to draw blood for a platelet count, as ordered, 1 hour after platelet administration to determine platelet transfusion increments.
Fresh frozen plasma (FFP):
Uncoagulated plasma separated from RBCs and rich in coagulation factors V, VIII, and IX; 5,8,9
volume 200 to 250 mL
Fresh frozen plasma (FFP) Indication:
- to correct an undetermined coagulation factor deficiency
- to replace a specific factor when it isnโt available
- to correct factor deficiencies resulting from hepatic disease
- WARNING!: FFP is no longer indicated for use as a volume expander because of its high load of clotting factors. Itโs also contraindicated as prophylaxis after cardiopulmonary bypass surgery or with massive blood transfusions.
Fresh frozen plasma (FFP) Administration:
- For FFP, use a straight-line I.V. set, and administer the infusion rapidly.
- Keep in mind that large-volume transfusions of FFP may require correction for hypocalcemia because citric acid in FFP binds calcium.
Cryo: Cryopercipitate:
often referred to as Cryo is the precipitated material obtained from FFP when thawed. It contains coagulation factors VIII and XIII;
8 & 13,
Bogen, von Willebrand factor, and fibronectin. It is given to prevent or control, bleeding in patients with hemophilia, von Willebrand disease, to correct low fibrinogen levels, and for other clotting disorders
Albumin 5% (buffered saline) and albumin 25% (salt-poor saline):
Small plasma protein prepared by fractionating pooled plasma; volume of 5%, 12.5 g/250 mL; volume of 25%, 12.5 g/50 mL