Blood Transfusion

1. Blood Transfusion Dr. Kareema Ahmed Hussein 2017 -2018

2. Blood Transfusion. • is the infusion of whole blood from a healthy person in to a recipient's vein of sick person . • Administration of blood or one of its components through an intravenous line (IV) • Reaches patient’s blood vessels • and enters the circulatory • system

3. Recipient : The person who receive the blood from another person • Donor : The person who give the blood { donates } to another person • Type of blood transfusion • 1-Indirect type : • Blood is infused after it has been collected from donor and processed this method is used most commonly . it's similar to giving I.V. in . • 2- Direct type : • Blood is infused as it's taken from donor this method is rarely except in emergencies

4. Typing and cross matching: [Blood compatibility] Before blood can be given to person it must be determined that the blood of the donor and the recipient are compatible. If they are no: clumping and hemolytic of the recipients blood cells will result . Typing The laboratory examination to determine person's blood type ABO. Cross matching: The process of determining compatibility between blood specimens . Antibody A substance that causes the formation of antibodies . Agglutinin An antibody that causes a clumping of specific antigens

5. Purpose of a Blood Transfusion • Restore blood volume • Replace clotting factors • Improve oxygen carrying capacity • Restore blood elements that are depleted • Prevent complications

6. 4 types • A • B • AB • O

7. Blood Typing • Most people have two related inherited antigens – A and B – that form the basis for the ABO blood typing • Individuals with A antigen have type A blood • Individuals with B antigen have type B blood • Individuals with both A and B have type AB blood • Individuals with no antigen have type O blood

8. Antibodies with each blood type: • Blood type A: Has B antibodies • Blood type B: Has A antibodies • Blood type AB: Has no antibodies • Blood type O: Has both antibodies( A&B) • The Rh factor is made up of numerous complex antigens • When it is present, the person is Rh positive (Rh+); if not present, the person is Rh negative (Rh–)

9. Blood compatibilities

10. Blood typing for transfusion • Universal donor= O- • Does not contain A, B, or Rh antigens • Universal recipients= AB+ • Blood contains A, B, and RH antigens • Usually blood banks exactly match the pt blood

11. Whole Blood • Composition: • Red Blood Cells • White Blood Cells • Plasma • Platelets • clotting Factors • Purpose: • Volume replacement • Increase oxygen-carrying capacity • Indications: • Significant blood loss (>25% blood lost, i.e. hemorrhage) • Newborn babies with hemolytic disease

12. Packed Red Blood Cells (RBCs) • Composition: • RBCs with little plasma • Some platelets and WBCs remain • Purpose: • Increase RBC mass and oxygen-carrying capacity • Assists the body to rid carbon dioxide and other waste products • Indications: • Symptomatic and chronic anaemia • Blood loss due to injury or surgery

13. Platelets • Composition: • Platelets • Plasma • Some of RBCs • Some of WBCs • Purpose: • Helps to stop bleeding (restore clotting ability) • Essential for coagulation of blood • Indications: • Decreased platelet count • Hemophilia • Thrombocytopenia • Platelet dysfunction (End stage renal disease, DIC)

14. White Blood Cells (WBCs) • Composition: • WBCs or leukocytes suspended in 20% of the plasma • Purpose: • Increase number of WBC’s • Replaces WBC’s that are functioning abnormally • Indications: • Sepsis (not responsive to antibiotics) • Persistent fever • Granulo-cytopenia

15. Fresh Frozen Plasma • Composition: • Plasma • All coagulation factors • Purpose: • Increase blood plasma • Replenish clotting factors • Indications: • Bleeding in patients with coagulation factor deficiencies. • Burn • Liver Failure • Severe Infection

16. Albumin • Composition: • Albumin • Purpose: • Volume expansion leading to increased blood volume • Indications: • Hypo-protein-anemia • Burns • Shock • Trauma • Surgery • Infections

17. selection of blood donors I -The accurate type . 2-The donor must be free from diseases ( hepatitis ) 3-The donor must be free from allergies . 4-The donor must be free from chronic diseases 5-Some banks don't accept blood donor who has been immunized recently because of possible allergic reaction to the blood .

18. typing and cross matching: [Blood compatibility] Before blood can be given to person it must be determined that the blood of the donor and the recipient are compatible. If they are no: clumping and hemolytic of the recipients blood cells will result

19. Nursing Implications Before transfusion: • Check physician’s orders • Review hospital policy • Ensure informed and written consent is provided • Check laboratory values • Compatibility of blood type and Rh factor • Understand the indications and rationale • Verification procedure occurs with two • nurses • Inspect the blood product for discolouration, clots, leaking, or presence of bubbles

20. Before transfusion (con’t): • Check the unit number on the unit of blood and on the form • Check the expiration date and time on unit of blood • Ask client to state first and last name • Check patient’s identification number on wristband and record • Use a 16-18 or 19 gauge needle or catheter to transfusion to prevent damage of red cells . • During the first 15 min. of transfusion the blood should be • administered slowly about 10-20 drop/mLto avoid complications • Stay with the pt. at first 15 min . to observe complications that may occur.

21. During the transfusion: • Monitor vital signs closely during the blood transfusion • Inspect condition of IV site • Observe for signs and symptoms of a reaction • The rate is increased after the 15 in according to the physician's orders . • Don't administer medications through the blood line { it may cause hemolytic).

22. After the transfusion: • Dispose of materials/equipment • Observe patient for clinical improvements • Assess the laboratory values for effectiveness of transfusion • The nurse must check the pt. For at least 5-1 0 min . after finshing

23. Documentation • Verification procedure • Type of blood • Amount administered • Vital signs • Patient’s response to therapy

24. Infusion Therapy Risks • Risk factors: • Disease transmission • Hepatitis B 1:140,000 • Hepatitis C 1: 225,000 • Hepatitis A 1:1 million • HIV 1: 1.5 million • Syphilis 1: 1 million • Bacterial contamination • Acute or delayed transfusion reactions • Mis-matched ABO 1: 35,000 • Incompatible Death Rate 1:600,000 • Circulatory overload

25. COMPLICATION 1-Febrile Reaction: Recipients hypersensitivity to the blood S/S fever ,chill, headache ,malaise, Onset after first 30 min. —6hr Management: Stop immediately IV. Continue IV normal saline. Notify the physician Monitor vital signs.(antipyretics as order.)

26. 2-Allergic reaction: Sensitivity to the plasma protein s/s rash, itching onset during or I hr after management: Stopping the IV and continue IV normal saline Antihistamine may be order. Comfortable

27. 3-Hemolytic reactions: onest immediately donors blood is incompatible with the recipient blood s/s facial flushing ,fever ,chills ,headache tachycardia,low BP ,blood in urine↑ 4-Sepsis:blood contamination by bacteria or dioxin onset within 2hrs. s/s chill ,vomiting ,diarrhea, low BP, shock

28. 5-circulatory overload: To rapid infusion expands the vascular volume more than patient heart can tolerate. S/s dyspnea, cough ,anxiety ,tachycardia, tachypnea ,cracorthopnea ,high BP . Management I -Elevate patient head. 2-Notify physician . 3-Stop or slow IV 4-Give morphine and diuretics ,oxygen as order

29. Thank You