Blood transfusion notes?

- Blood transfusion is the process of transferring blood or blood products from one person (donor) into the bloodstream of another person (recipient).
- It is commonly used to replace blood lost during surgery or injury, treat certain medical conditions such as anemia or hemophilia, or to improve the overall health of a patient.
- Before a blood transfusion, both the donor and recipient are carefully matched to ensure compatibility and reduce the risk of complications.
- Blood transfusions can be done with whole blood, packed red blood cells, platelets, plasma, or other blood components depending on the specific needs of the recipient.
- Risks associated with blood transfusions include allergic reactions, infections, and transfusion-related acute lung injury (TRALI).
- Patients receiving a blood transfusion should be closely monitored for signs of adverse reactions, such as fever, chills, shortness of breath, or chest pain.
- It is important for healthcare providers to follow strict protocols for blood transfusions to ensure patient safety and prevent complications.

Blood Transfusion

Indications

- Severe anemia (Hb < 7 g/dL)
- Acute blood loss
- Exchange transfusion in newborns

Types of Blood Transfusions

- Red blood cells (RBCs)
- Platelets
- Whole blood
- Plasma

Assessment Before Transfusion

- Patient identification: Confirm patient's name, date of birth, and hospital identification number.
- Medical history: Obtain information about allergies, recent transfusions, and any underlying conditions.
- Physical examination: Assess vital signs, skin color, and mucous membranes for signs of anemia or blood loss.
- Blood type and crossmatch: Verify patient's blood type and perform a crossmatch with donor blood to ensure compatibility.

Procedure

- Obtain an informed consent from the patient or legal guardian.
- Prepare the patient with intravenous access.
- Connect the blood transfusion bag to the IV line and adjust the rate according to physician orders.
- Monitor the patient closely during the transfusion.

Monitoring During Transfusion

- Vital signs: Monitor blood pressure, heart rate, temperature, and oxygen saturation.
- Respiratory: Auscultate breath sounds for any signs of respiratory distress.
- Skin and mucous membranes: Observe for any signs of rash, redness, or swelling.
- Urine output: Monitor urine output to ensure adequate hydration.

Possible Complications

- Transfusion reactions:
- Hemolytic: Destruction of donor RBCs due to ABO or Rh incompatibility.
- Allergic: Hypersensitivity reaction to plasma proteins.
- Febrile non-hemolytic: Mild fever and chills without hemolysis.
- Circulatory overload: When the transfusion rate is too fast or the patient's circulatory system cannot tolerate the extra volume.
- Transfusion-related acute lung injury (TRALI): A severe lung injury caused by antibodies in donor plasma.
- Infection: Transmission of bloodborne pathogens such as HIV or hepatitis.

Nursing Interventions

- Pre-transfusion:
- Verify patient's identity and crossmatch results.
- Explain the procedure and address any concerns.
- Monitor vital signs and prepare IV access.
- During transfusion:
- Monitor the patient closely for any adverse reactions.
- Adjust the transfusion rate as ordered.
- Educate the patient on potential complications.
- Post-transfusion:
- Monitor the patient for signs of delayed transfusion reactions.
- Document the transfusion, including the type of blood products transfused, amount, and duration.
- Encourage the patient to drink plenty of fluids and rest.