Blood transfusions

Question 1

What equipment is needed for blood transfusions?

Answer 1

Equipment Needed
- Blood administration sets: 170-200 micron filter to remove clots and debris (change every 12 hours)
- Rapid infusion devices: used to warm and administer blood rapidly (during critical bleeding, massive transfusion)
- Pumps: used when free flow gravity is unreliable
- Syringe Drivers: continuous infusions of coagulation factors

Question 2

What are the types of blood products?

Answer 2

Blood Products
1. Red cells: to carry oxygen to tissues and organs
2. Platelets: To stop bleeding
3. Plasma: Blood clotting factors
4: FFP: fresh frozen plasma used for patients with cogolopathy who are at risk of bleeding

Question 3

What are the nursing responsibilities with blood transfusions?

Answer 3

Nursing responsibilities:
1. Initial set of observations
- perform every 15 mins until conclusion
- set at end of transfusion
- every 4th hourly for 24hrs
2. Legal Responsibilities
- two RNs needed at patient bedside
- Right pt, right blood, right back
3. Monitoring for adverse reaction transfusions
- mild: rash
- Severe: allergy, anaphylaxis, wheezing
- febrile: unexpected fever, vomiting
- Septic reaction: chills, rigor, hypotension, dyspnoea, bleeding

Question 4

How do you escalate a blood transfusion reaction?

Answer 4

Escalating if reaction:
1. Stop the infusion
2. Check vitals / provide emergency care, MET call, seek urgent advice
3. Maintain IV access, Do not flush existing line
4. Repeat all clinical checks and identity checks of pt and blood product
5. Notify medical officer and transfusion service provider
6. Continue to monitor and record vital ops and UO looking for signs of haemoglobinuria
7. Send freshly collect blood and urine samples, blood products, IV line connected, clamped sealed for transport as required by the transition