Paediatric - CLE - Blood Transfusions

Question 1

Indications for blood products

Answer 1

• anemia
• blood loss / haemorrhage
• cardiac dysfunction
• anemia due to renal failure / cancer
• bone marrow suppression
• haemoglobinopathies - sickle cell / thalassaemia

Question 2

Types of blood products

Answer 2

• Red Blood Cells
  
  • carry oxygen & remove carbon dioxide
  • indicated in anemia, conditions where RBCs don’t function as they should & people with severe bleeding / haemorrhage
• Platelets
  
  • components of blood that assist with clotting
  • indicated in cancer patients, with bone marrow suppression, people receiving chemotherapy, severe blood loss
• Plasma
  
  • fluid in which RBCs, WBCs & platelets are suspended, contains all coagulation factors
  • indicated in replacement of clotting factors - surgery, trauma, diseases which impair clotting - ie - liver disease

Question 3

Procedure for checking of blood products

Answer 3

• ensure patient & pack labels match, everything is doubled checked
• gain consent, inform patient of possible risks
• right patient, right product, right pack
• bag is intact, no clots, unusual colouring, turbidity

Question 4

Administering blood products

Answer 4

• ensure consent has been gained
• double check product at bedside, 2 nurse checks
• baseline obs, TPRBP
• resuscitation equipment is available and working
• check obs again after 15 minutes have passed
• checks obs during delivery of pack as per protocol
• check obs when the pack finishes transfusing
• clinical features of reaction - fever, chills, uricaria, tachycardia, hypotension, dynpnoea, rigors, nausea, vomiting, pain in IV site, anxiety

Question 5

Documentation for bloods

Answer 5

• need crossmatched sample prior to administration
• document blood pack donation number
• observations during transfusion
• volume of blood transfused, start & finish times
• if the blood administration had the desired effect