Transfusion Administration (ASAN002/18) Flashcards
Product Preparation
General Tips:\nCheck product\nThawing & Heating\nGiving sets etc.
Check product to be used:
Check it’s the correct product you need.\nEnsure it’s ‘in date’ & correct colour & consistency.\nCheck it’s not damaged (bag split etc)
Thawing & Heating:
Frozen & refrigerated products – warm to 37℃ before administration.\nWarm gently – excessive heating will damage proteins, clotting factors & O² carrying capacity of RBC’s.\nPlace product in plastic bag when thawing – to prevent contamination of product. (e.g. if bag is split but not obvious on initial inspection).
Administering Blood Products:
Always administer via blood admin set – has filter that removes debris &/or clots formed during storage.\nMake note of product ID – e.g. blood group, donor, time etc.
Routes of Administration:
Intravenous\nIntraosseous\nIntraperitoneal
Intravenous
Ideal route of administration for blood & blood products.\nUse the largest bore catheter for patient size – facilitate flow of blood or blood product (depending on product being transfused).\nIV admin ensures 100% rapid absorption.\nFlow rate can be changed as required (ie. if signs of reaction occur – infusion can be stopped immediately).
Intravenous – Administration:
DO NOT administer blood or blood products with HARTMAN’S – haemolysis will occur.\nUse 0.9% NaCl if crystalloids are to be administered with product. \nAlways use a filtered giving set – removes any micro thrombi that may have formed.
Intraosseous
Preferred route in neonate & paediatric patients – due to small size of both patients and veins. \nRoute enables 95% of RBC’s to be in the peripheral circulation within 5 mins of administration.\nInfusion rate can be controlled & changed as required.
Intraperitoneal
Not recommended for administration of blood or blood products.\nActual absorption rate is very low & rate of admin cannot be monitored or changed.
Time & Rates for Transfusions
Blood transfusions should be completed within 4hrs – to prevent bacterial contamination.\nOnly 0.9% Saline should be used for dilution of blood products.\nNo medications or additives should be added to transfusions.
FWB & SWB infusion rate in HYPOVOLAEMIC patients:
Up to 20ml/kg/hr
FWB & SWB infusion rate in NORMOVOLAEMIC patients:
5 – 10ml/kg/hr
FWB & SWB infusion rate in patients with CARDIAC DISEASE or RENAL FAILURE:
2ml/kg/hr
Increasing PCV calculation:
When you administer:\n2.2ml blood/kg, PCV will ↑ by 1%.
Transfusion Rate guidelines:
Transfusions should always be started at a slow rate under constant monitoring patient – observe any signs of reaction.\nInitial rate started at 0.25ml/kg for 15 – 30 mins, then ↑ rate.
If blood is administered to Tx acute haemorrhage:
Volume lost by patient should be estimated & replaced rapidly.
Formula generally used when calculating the amt of blood required to correct ↓ PCV:
Volume required = \nDesired PCV – Recipient PCV \n÷ Donor PCV x Recipient blood volume.
Total Blood Volume in L:
Can be estimated as approx. 8% of bodyweight (kg) = 80ml/kg
Example – Calculating Blood Volume required:
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Calculation #1:
Remember:\n2.2ml/kg of blood will ↑ PCV by ∽ 1%\n\n\n(32.5kg BW) x (2.2ml/kg/1%↑PCV) x (10% ↑ PCV)\n= 715mls of blood
Calculation #2:
Remember:\nVolume req = (desired PVC – recipient PCV) ÷ donor PCV x recipient blood volume.\nApprox. 8% of dogs BW(g) is blood (mls)\n\nCalculated blood volume of patient\n= 32,500gms x 8% = 2600gms = 2600mls\n\n\n(30% – 20%) ÷ 42% x 2600mls = 619mls of blood required.
Same Calculation for FWB can be used for PRBC’s:
The PCV of the PRBC’s is used instead of donor PCV.
IMAGE – Summary of Dosage Guidelines
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