Blood Transfusion Flashcards
How do you identify patients in a blood transfusion
- first name
- last name
- date of birth
- NHS number
what do you need to do for the patient before transfusion
- risk and benefits need to be explained to the patient
- provide the patient information leaflets where possible
What are the pre-transfusion checks
- is the transfusion appropriate and prescribed appropriately
- why do they need the transfusion
- document clearly the reason for the transfusion
- summary of information provided to the patient e.g. - everything that was discussed with the patient and the patients consent
What should be on a blood transfusion prescription
- write down the components to be transfused
- date of transfusion
- volume to the transfused and the rate/duration of transfusion
- any special requirements
When requesting the transfusion what needs to be included
- patient identifiers
- diagnosis and reason for the transfusion
- component required, volume/number of units
- time and location of the transfusion
- name and contact number of the requester
what is a cross match blood sample
- this is the blood sample that is taken pre-transfusion to determine the type of blood that the patient will require
- sample tubes should be labelled at the patients bedside to avoid errors - they should not be pre-labelled
- request form should be signed by the person taking the sample at the bedside as well
How do you check the blood product when it is delivered
- pack integrity
- clots
- evidence of haemolysis in the plasma or at the interface between red cells and plasma
What final checks are done prior to the administration
- all patients must be positively identified
- most trusts state the blood must be checked by 2 members of staff
- all components must be administered through a blood administration set
what bedside checks do you do when you administer the blood
- ask the patient to tell you their name and date of brith
- check this against their ID band
- if the patient is confused or unconscious, a relative or staff member who knows the patient can confirm these details
Check - full name - date of brith - hospital number on the patients ID band against the compatibility label
Check
- the blood unit number on the compatibility label against the blood unity number on the blood bag label
- the blood group and Rh status of the donor and the blood group and Rh status of the blood label match those recorded on the compatibility label
- the expiratory date on the blood bag label
What baseline observations do you need to carry out before setting up the blood transfusion
- blood pressure
- temperature
- respiratory rate
- pulse
- oxygen saturations
- urine output
What needs to be monitored during the transfusion
- blood pressure
- temperature
- RR
- pulse
- oxygen saturations
- urine output
What symptoms should you ask the patients to report
- chest/loin pain
- feeling unwell
- shortness of breath
- rashes
- a restless/anxious feeling
- abdominal discomfort
What do you do in an adverse reaction
- Stop the transfusion
- maintain venous access
- check ABC and examination
- check ID of patient against ID details of the unit
- call senior and specialist help
- obtain bloods
- emergency drugs and crash trolley
- retain any unfinished infusion
- close monitoring of vital signs
Why do some patients require blood transfusion
- low haemoglobin
- blood loss
- symptomatic anaemia
What are the different types of blood products
- whole blood
- red blood cells
- platelets
- fresh frozen plasma
- cryoprecipitate
- prothrombin complex concentrate
