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TRANSFUTION THERAPY * REPLASEMENT * THERAPUTIC1.To restore intravascular volume with whole blood or albumin.2. To restore the oxygen capacity of blood by replacing red blood cells.3. to replace clotting factor and correction of anemia : TRANSFUTION THERAPY * REPLASEMENT * THERAPUTIC1.To restore intravascular volume with whole blood or albumin.2. To restore the oxygen capacity of blood by replacing red blood cells.3. to replace clotting factor and correction of anemia PURPOSE OFBLOOD Slide 7: WHAT IS CROSS MATCHING ? Cross matching is the process of dermining compatibility between blood specimens Slide 8: WHAT IS BLOOD GROUP ? Bloood group is an inherited trait,is determined by the type of antigens and antibodies present in the blood BLOOD TYPES A - B - AB - O Slide 9: RH Negative Positive Slide 10: WHAT IS ANTIGENS ? An antigens is a substance that causing the formation of antibodies WHAT IS ANTIBODYS ? Antibodies is a protein substance develop in the body in response to the presence of an antigen that has entered the body Slide 11: DONOR The person giving the blood RECIPENT The person receiving the blood Slide 12: Blood product transfusions sometimes cause transfusion reactions. There are several types of reactions and some are worse than others. Some reactions happen as soon as the transfusion is started, while others take several days or even longer to develop. Slide 13: what is blood transfusion reaction ? It is abnormal signs and symptoms that will occur during or after transfusion and effects the patiens health Slide 15: Prevention ASSESSMENT before transfusion ask the patient about past reaction. If patient has history of reaction, alert health care provider , have emergency drugs available,and remain at bed side for the first 30min. Slide 17: Prevention ASSESSMENT Give antipyretic before transfusion as directed Leukocyte – poor blood products may be recommended for future transfusion Slide 19: Prevention do not permit blood to stand at room temprature longer than necessary. warm temperatures promote bacterial growth. inspect blood for gas bubbles, clotting or abnormal color. Slide 21: Prevention concentrated blood products should be given whenever positive. transfuse at a rate within the circulatory reserve of the patient. monitor central venous pressure of patient with heart disease. Slide 23: MANAGEMENT STOP TRANSFUSIOM IMMEDIATEL KEEP VEIN OPEN with 0.9% saline. Notify doctor , infection control, blood bank treat shock if present draw testing samples, collect urine samples. maintain blood pressure with IV colloid solutions. administer prescribed diuretic,to maintain blood flow, glomerular filtration, and renal blood flow. monitor hourly urin output. Patient may require dialysis if renal falure occures PREVENSION Verify patient identification from sample collection to product infusion. Begin infusion slowly and observe closely for 30 min.- consequences are in proportion to the amount of incomatible blood transfosed Slide 24: PREVENSION the crossmatch blood sample should be drawn within 3 days of blood transfusion. antibody Formation may occur within 90 days of transfusion or pregnency. Slide 25: NO PREVENSION Slide 27: PREVENSION OF DELAYED REACTION Proper blood screening In case of malaria – doner should be asked if he has cold,flu or foreign travel Slide 28: GENERAL CONCEDERATIONS TO PREVENT BLOOD TRANSFUSION REACTION Slide 29: DONORS Blood donors must be selected with care. Donors should be healthy & free of diseases. Donors should be examined carefully at the time of donation. Blood donated from people who have allergies or those with a history of a chronic diseases, such as tuberculosis, certain types of cancer, and hemophilia, is usually not used. Slide 30: For precaution some blood banks don’t accept blood from a donor who has been recently immunized because of a possible allergic reaction Individuals may give blood only if their blood count, temperature, pulse, respiration, blood pressure, and weight are within normal range Slide 31: LABORATORY Blood screening for infectious diseases. Proper storage (4 ̊ C) Antibody screening Blood compatibility -RH To protect the donor from possible risks of donation and protect the patient from the risk of transfusion Slide 32: PATIENT Previous allergic reaction Consent Name and phone number of a contact person in case of emergency Slide 33: DOCTOR The physicians order should specify Blood component, volume, and rate of transfusion Slide 34: NURSE Only trained and qualified nurses are allowed to perform the blood transfusion steps Slide 35: NURSE Sending blood sample for cross matching with CLEAR and CORRECT Patient name, file number, room number, age, sex, department, bed number, date,time,nurse name and signature Slide 36: BEFORE receiving blood Doctor order Consent Patient assessment Premedicate the PT.30min. before transfusion for TABs & before transfusion is initiated for IV NURSE Slide 37: PREPARE THE EQUIPMENT Having equipment available saves time and facilitates the task. Blood filter designed to trap fibrin clots ,broken blood cells and other debris that accumulate during blood storage Slide 39: Multi-lead tubing Slide 40: ICE BAG, WARM COMPRESSES NORMAL SALINE Slide 45: Before receiving blood or blood product IV cannula to be inserted & maintained at a KVO rate. Slide 46: while receiving the blood nurse should verify client identity, blood group, RH compatibility. this can usul. Slide 48: LABPRATORY STAFF DONORS BEFORE receiving blood DURING Instruct the client Remain with the patient-15min V/S – every hour until 1hr after transfusion Blood components are infused within standard time limits ( 4 hours) AFTER Healthy donors Blood screening for infectious diseases. Blood compatibility – RH Proper storage Antibody screening Doctor order Consent Patient assessment Preparation-IV cannula Equipment - Multi-lead tubing Premedicate the PT.30min-TAB. before transfusion - IV AFTER receiving blood Check blood Patient identity Patient assessment – bed side Close opservation to the pt. Proper dispose of IV tubing/bag Decumintation : Identification of blood & blood products is performed at the patient’s bedside by two LICENSED PROFESIONALS,QUALIFIED NURSES according to the facility’s policy. Slide 51: Blood should be transported and transfused to only one patient at the time Slide 52: Hand hygiene prevents the spread of microorganisms . Gloves protect against accidental exposure to the patients blood. Slide 53: If you’re administering whole blood, gently invert the bag several times to mix the cells. Slide 54: Start the administration slowly (no more than 25 to 50 ml for the first 15 minutes of transfusion Slide 55: Medication are NEVER added to blood or blood products. Slide 56: If no signs of a reaction appear within 15 minutes, you’ll need to adjust the flow clamp to the ordered infusion rate. Slide 57: Then remember to reconnect the original I.V. fluid, if necessary, or disconnect the I.V. infusion. Practice Pointers : Practice Pointers Although some microaggregate filters can be used for up to 10 units of blood, always replace the filter & tubing if more than 1 hour elapses between transfusions. Slide 59: In case of emergency, When administering multiple units of blood, use blood warmer to avoid hypothermia. Slide 60: Blood has not been used within 30minutes after its arrival from the blood bank must be RETURNED , blood that has been infusing for more than 4hrs must be DISCONTINUED to prevent the risk of BACTERIAL CONTAMINATION. 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