Blood Transfusion (a nursing procedure) by

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Information about Blood Transfusion (a nursing procedure) by
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Published on July 11, 2008

Author: blueash



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BloodTransfusion Nursing Procedure

*Whole blood transfusion replenishes the circulatories: Volume Oxygen-carrying capacity*Packed Red Blood Cells (RBCs) restores: Oxygen-carrying capacityBoth treat decreased hemoglobin and hematocrit.

Two nurses must identify the:1. Patient2. Blood productsbefore administering a transfusion (to prevent errors & potentially fatal reaction)

If a patient is a Jehova’s Witness, a transfusion requires special written permission.

Equipments needed1. Blood recipient set (filter & tubing with drip chamber for blood, or combined set)

Equipments needed2. I.V. pole3. Gloves4. Gown5. Face Shield

Equipments needed6. Multi-lead tubing

Equipments needed7. Whole blood or packed RBC’s

Equipments needed8. 250 ml of Normal Saline Solution

Equipments needed9. Venipuncture equipment, if necessary (should include 20G or larger catheter)

Equipments needed10. optional: ice bag, warm compresses

Getting ReadyAvoid obtaining either whole blood or packed RBC’s until you’re ready to begin the transfusionPrepare the equipment when you’re ready to start the infusion.

The ProcedureExplain the procedure to the patientMake sure an informed consent has been signedRecord baseline vital signs

The ProcedureObtain whole blood or packed RBCs from the blood bank within 30 minutes of the transfusion start time.

The Procedure Check the expiration date on the blood bag, & observe for abnormal color, RBC clumping, gas bubbles, & extraneous material. Return outdated or abnormal blood to the blood bank.

The ProcedureCompare the name & number on the patient’s wristband with those on the blood bag label.

The ProcedureCheck the blood bag identification number, ABO blood group, and Rh compatibility.Also, compare the patient’s blood bank identification number, if present, with the number on the blood bag.

The ProcedureIdentification of blood & blood products isperformed at the patient’s bedside by twolicensed profesionals, according to thefacility’s policy.

The ProcedureWash your hands.Put on gloves, a gown, & a face shield.

Remove IV administration set and fluid from packaging

Remove the cover from the selected spike and the cover from the bottle/bag of fluid.

The ProcedureThen insert the spike of the line you’re using for the normal saline solution into the bag of saline solution aseptically.

When fluid drips out of the end of the distal tubing turn off the infusion rate clamp.

The ProcedureUsing a Y-type set, close all the clamps on the set.

The ProcedureNext, open the port on the blood bag & insert the other spike.

The ProcedureHang the bags on the I.V. pole,

The Procedureopen the clamp on the line of saline solution,

The Proceduresqueeze the drip chamber until it’s half full.

The ProcedureIf the patient doesn’t have an I.V. line in place, perform venipuncture, using a 20G or larger-diameter catheter.

The ProcedureAvoid using an existing line if the needle or catheter lumen is smaller than 20G.Ventral venous access devices also may be used for transfusion therapy.

The ProcedureIf you’re administering whole blood, gently invert the bag several times to mix the cells.

The ProcedureAttach the prepared blood administration set to the venipuncture device, & flush it with normal saline solution.

The ProcedureThen close the clamp to the saline solution, & open the clamp between the blood bag & the patient.

The ProcedureAdjust the flow clamp closest to the patient to deliver the blood at the calculated drip rate.

The ProcedureRemain with the patient, & watch for the signs of a tranfusion reaction, such as fever, chills, & wheezing.

The ProcedureIf such sign develop, record vital signs and stop the transfusion.

The ProcedureInfuse saline solution at a moderately slow infusion rate, & notify the doctor at once.

The ProcedureIf no signs of a reaction appear within 15 minutes, you’ll need to adjust the flow clamp to the ordered infusion rate.

The ProcedureA unit of RBCs may be given over 1-4 hours as ordered.

The ProcedureAfter completing the transfusion, you’ll need to put on gloves & remove & discard the used transfusion equipment.

The ProcedureThen remember to reconnect the original I.V. fluid, if necessary, or disconnect the I.V. infusion.

The ProcedureReturn the empty blood bag to the blood bank, & discard the tubing & filter.

The ProcedureRecord the patient’s vital signs.

Practice PointersAlthough some microaggregate filters canbe used for up to 10 units of blood, alwaysreplace the filter & tubing if more than 1hour elapses between transfusions.

Practice PointersWhen administering multiple units of blood, use blood warmer to avoid hypothermia.

Practice PointersFor rapid blood replacement, know thatyou may need to use a pressure bag.

Practice PointersIf you’re administering packed RBCs withY-type set, you can add saline solution tothe bag to dilute the cells by closing theclamp between the patient & the dripchamber & opening the clamp from theblood

Practice PointersThen lower the blood bag below the salinesolution container & let 30-50ml of salinesolution flow into the packed cells.

Practice PointersFinally, close the clamp to the blood bag,rehang the bag, rotate it gently to mix thecells & saline container

Documenting Blood TransfusionIn your notes, record:Date & time of the transfusion.Type & amount of transfusion product.Patient’s vital signs.Your check of all identification data.Transfusion reaction & nursing actions taken.

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