BLOOD TRANSFUSION

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PRESENTED BY: KIRAN RANDHAWA:

PRESENTED BY: KIRAN RANDHAWA BLOOD TRANSFUSION

COMPONENT OF BLOOD:

COMPONENT OF BLOOD Blood plasma -Water (91.5%) -Proteins (7%) -other solutes (1.5%) Formed element -Red blood cell -White blood cell -Platelets

DEFINITION:

DEFINITION A transfusion is the transfer of whole blood or blood components such as blood cells & plasma from one person to another person.

PURPOSE:

PURPOSE To replace the blood volume To increase the oxygen carrying capacity To provide Hb & WBC in severely ill patient To correct the deficiency of plasma protein To combact infection in leukopenia

CONTD………….:

CONTD…………. To replace the blood with haemolytic agents with fresh blood. To provide antibodies .

INDICATION:

INDICATION Anaemia sudden loss of blood due to haemorrhage, trauma or burn. Deficiencies of plasma protein ,clotting factor & haemophilic globulin etc. Erythroblastosis foetalis, haemolytic, etc. Agranulocytosis, leukopenia

TYPES OF BLOOD GROUPS:

TYPES OF BLOOD GROUPS ABO blood group Rh group Group A Rh –ve Group B Rh +ve Group AB Group O

ABO Blood Grouping procedure:

ABO Blood Grouping procedure Slide or tile method. Tube method. Microplate method. Gel technology. Bead technology.

BLOOD GROUPING & CROSS MATCHING:

BLOOD GROUPING & CROSS MATCHING For ABO typing , single drops of blood are mixed with different antisera, solution that contain antibodies.

BLOOD GROUPING & CROSS MATCHING:

BLOOD GROUPING & CROSS MATCHING For determining Rh factor ,a drop of blood is mixed with antiserum containing Ab that will agglutinate RBCs displaying Rh antigens In a cross match the donor RBC s are mixed with recipients serum if agglutination dose not occur ,the recipient dose not have Ab that will attack the donor RBC s

Slide 12:

Anti D Anti B Anti D Anti A Anti B

Use of tooth pick to mix Blood and Anti Sera. :

Use of tooth pick to mix Blood and Anti Sera.

Slide 16:

Slide testing shows Group is A-ve

BLOOD PRODUCTS :

BLOOD PRODUCTS Packed RBC s (1u =250-350ml) Frozen RBC s (stored for 3 yrs at –188.6 0 F) Platelets (1u=30-60ml of platelet) Fresh frozen plasma (1u =200-250 ml) Albumin( available in 5% or 25% soln) Cryoprecipitates (10-20ml/ bag)

SELECTION OF DONOR :

SELECTION OF DONOR Donor should be free of diseases of heart , kidneys,lungs, liver etc There should be no history of chronic illness Not donated blood within the previous 90 days They should be physically healthy & between 18-65 yrs of age

CONTD….:

CONTD…. Donors vitals signs should be normal Not have been pregnant within the last 6 months Hb should be greater than 12gm/dl Donors are disqualified who have H/O recent dental surgery,major surgery , recipient of blood, immunization & use of narcotics

Slide 23:

Donor screening Screening of the donor questionnaire Weight Hemoglobin checking ABO grouping

NURSING INTERVENTION :

NURSING INTERVENTION Explain the procedure to the donor Blood should not be collected empty stomach Before the donor is allowed to leave the hospital ,his vitals should be checked & ask if he had any dizziness. Check the vital signs

Slide 25:

Management of vasovagal reaction in sitting position . Put the head on to the knee. Ask the donor to cough. Do not leave the donor alone .

COLLECTION ,STORAGE & TRANSPORTATION OF BLOOD:

COLLECTION ,STORAGE & TRANSPORTATION OF BLOOD The donors blood is collected into a container with anticoagulation soln All article should be sterile Donor unit must be labelled clearly

CONTD ……:

CONTD …… After collection it should be stored at 1-6 o c Stored blood should be inspected daily The transportation of stored blood should be within 30 min.

NURSING INTERVENTION:

NURSING INTERVENTION Pre procedure - confirm that transfusion is prescribed -take the consent of the patient -Check that blood has been typed & cross-matched -Explain the procedure to patient - Take the vitals

CONTD……:

CONTD…… - Use hand wash & wear gloves - Use 20-g or larger needle for packed RBC s -Use 22-g or larger needle for FFP

DURING PROCEDURE:

DURING PROCEDURE Obtain the blood or the components from the blood bank Double check the labels Check the products for any unusual color or clumps In case of packed RBC s ,transfusion is initiated within 30 min after removal from blood bank

DURING PROCEDURE CONTD…….:

DURING PROCEDURE CONTD……. Platelets or FFP units should be immediately administered For packed RBC s transfuse I ST 15 min slowly, not faster than 5ml/min For FFP infuse each unit as fast as patient can tolerate Observe the patient closely through out the transfusion

DURING PROCEDURE CONTD……..:

DURING PROCEDURE CONTD…….. In case of packed RBC s infusion time should not exceed 4 hr Be alert for signs of adverse reaction Change blood tubing after every 2 units Flush line with saline after transfusion

POST PROCEDURE:

POST PROCEDURE Obtain vital signs & compare with baseline measurement Dispose of waste materials properly Document procedure in patients medical record Moniter patient for response to & effectiveness of procedure

TRANSFUSION COMPLICATION:

TRANSFUSION COMPLICATION Acute transfusion Delayed Reaction transfusion reaction

ACUTE TRANSFUSION REACTION:

ACUTE TRANSFUSION REACTION 1 . Acute hemolytic reaction -infusion of ABO incompatible blood antibodies in the recipients plasma attach to antigens on transfused RBC s causing RBC s destruction

ACUTE TRANSFUSION REACTION Contd……:

ACUTE TRANSFUSION REACTION Contd…… 2. Febrile non hemolytic -sensitization to donor WBC s, platelets or plasma protein 3. Mild allergic reaction -sensitivity to foreign plasma proteins 4. Anaphylactic & severe allergic reaction 5. Circulatory overload 6 . sepsis

DELAYED TRANSFUSION REACTION :

DELAYED TRANSFUSION REACTION Delayed hemolytic reaction Iron over load Disease transmitted by transfusion -hepatitis B & C - AIDS - cytomegalovirus -graft Vs host disease

NURSING MANAGEMENT FOR TRANSFUSION REACTION:

NURSING MANAGEMENT FOR TRANSFUSION REACTION Stop the transfusion Maintain the IV line with normal saline, administer at slow rate Assess the patient carefully Monitor the vital signs carefully Inform the physician of the assessment findings

CONTD……..:

CONTD…….. Notify the blood bank that a transfusion reaction case has occurred Send the blood container & tubing to the blood bank Obtain appropriate blood sample from patient

CONTD……..:

CONTD…….. Collect a urine sample for Hb determination Document the reaction according to institutions

SUMMARISATION:

SUMMARISATION Components of blood Definition Type of blood group Selection of donor Collection & storage of blood Nursing intervention -pre ,during & post

CONTD……:

CONTD…… Transfusion complications Nursing management of complications

Slide 44:

THANKS

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