Blood transfusion

Question 1

How long should a standard unit of red cells (in a non-resus situation) be given over?

Answer 1

4 hours (about 19/20 drips per minute)

Question 2

Monitoring requirements for giving blood transfusion?

Answer 2

Record obs at 0, 15, 30 minutes and then hourly thereafter

Question 3

If a patient is elderly or has heart failure, consideration should be given to prescribing what?

Answer 3

Furosemide with the 2nd and 4th bags of packed red cells

Question 4

What should the patient be counselled about before the transfusion? (4)

Answer 4

Reason for transfusion e.g. profound anaemia
Immune complications
Infectious complications
Risk of fluid overload

Question 5

Immune complications? (4)

Answer 5

Acute haemolytic reaction (ABO)
Delayed haemolytic reaction (other antigens e.g. Rhesus, Kell)
Non-haemolytic e.g. febrile, urticarial, anaphylaxis
TRALI

Question 6

Potential infectious complications

Answer 6

BBV- hepatitis, HIV, other viruses
Bacteria
Parasites

Question 7

Potential complications of massive transfusion (>10 units) (4)

Answer 7

Hypothermia
Coagulopathy
Hyperkalaemia
Acid/base disturbances