Safe Transfusion

Question 1

Universal donar

Answer 1

O negative

Question 2

Universal recipient

Answer 2

AB positive

Question 3

Why can O blood be given safely to all groups in a life threatening situtation

Answer 3

There are no A or B antigens to react with the recipients antibodies

Question 4

Incompatible ABO group reactions

Answer 4

Massive immune response leading to:

shock and Disseminated Intravascular coagulation.

Death from: circulatory collapse, severe bleeding or renal failure within minutes or hours

Question 5

What legislation governs transfusion documentation

Answer 5

UK Blood Safety and Quality Regulations

Decision to transfuse must be recorded in the case note
record of administration of each blood component
proof of fate of components whether transfused or discarded

Question 6

Why shouldn’t you prime an administration set with Dextrose or Ringers Lactate

Answer 6

Can cause haemolyis or lead to clotting of transfused components

Question 7

Why cant platelets be administered through a set previously used for red cells or other components

Answer 7

Could cause aggregation of cells

Question 8

Why should administration sets have mesh filter

Answer 8

to remove mircoraggregates

Question 9

What documented MUST be completed for each component transfused

Answer 9

Donor number
date and time of transfusion
Signature of persons undertaking checking procedure
should be completed on traceability and hospital transfusion documentation

Details of transfusion must be included
IF blood component not transfused must inform HTL so that full traceability maintained

Question 10

Signs and symptoms of mild transfusion reaction

Answer 10

Pyrexia

Question 11

Signs and symptoms of severe transfusion reacton

Answer 11

Pyrexia, rigors (shivering)
Hypotension
Loin/Back pan
increasing anxiety
pain at infusion site
respiratory distress
dark urine
severe tachycardia
unexpected bleeding  DIC) late stage

Question 12

Management of Severe Transfusion Reaction

Answer 12

1.STOP the transfusion
Replace admin set, maintain IV access with normal saline to maintain systolic BP,check patient and component compatibility)

2. Call doctor to see patient urgently..
3. Assess patient (Check urine for signs of hameoglobinuria, commence appropriate treatment; Maintain airway, give high flow O2, administer adrenaline and/or diuretic and resuscitate
4. Inform HTL and return component
5. Document event in patient notes

Question 13

Management of mild transfusion reaction

Answer 13

Stop transfusion (check patient and component compatibility)
Seek medical advice
Assess patient
Commence appropriate treatment

If signs and symptoms worsen within 15 minutes treat as severe reaction

Question 14

Haemolytic transfusion reaction

Answer 14

Rare type of transfusion reaction usually seen in patient who have developed red cell antibodies from a past transfusion or pregnancy.

Symptoms occur days after the transfusion suggesting that cells are being destroyed abnormally quickly

fever
falling Hb or a rise in Hb less than expected
jaundice
haemoglobinuria (black wee wee)

Question 15

Hazards of transfusion?

Answer 15

Administration of wrong blood
Wrong blood in tube
Inappropriate or unnecessary blood transfusion
Handling and storage errors (biggest source)
Lab errors