Blood Transfusions Blood products (p.731) PRBC’s Frozen PRBC’s Platelets FFP Albumin

Indications for Blood Products Management of hematologic diseases Hemorrhagic conditions No blood substitutes

Safety of Blood Products Screening of blood donors What if donor is not truthful? Blood is tested by the collection agency Locally-American Red Cross Know blood type

Equipment IV site for blood product Large bore needle (18-20 gauge) Saline (never dextrose) IV pump Blood tubing Has “Y” adaptor Special filter Use once

Nursing Responsibilities Patient knowledge base/permission Religious preference History of prior transfusions/reactions Review MD orders T&CM/lab Blood band/red Document

More Responsibilities Initiate IV site Obtain Vital Signs prior to blood product Obtain blood product from lab Have second RN verify blood product Monitor for reactions Administer over 2-4 hours per MD order Post administration VS

During Administration of Blood Products Stay with individual for the first 15 minutes Observe IV site for complications Should reaction occur-STOP transfusion Give fluids in second IV site Don’t flush remainder of blood in tubing into the patient

Post Transfusion Obtain VS Document VS Continue to monitor for complications Assess for FVE Prepare for second transfusion Document

Complications (Lewis p. 733) Acute Hemolytic Reaction Febrile non-hemolytic Allergic reactions Circulatory Overload Sepsis

Delayed Reactions (Lewis p.734) Hepatitis B Hepatitis C Iron Overlaod

Conclusions Blood product administration is serious Know your equipment Be familiar with facility policy Monitor the recipient Document