It is the process of intravenous administration of blood and its products into circulation. This is done when there are obvious signs of anaemia and a low haemoglobin level.
Aims
· Replenish/restore blood or blood products in children
· Remove and replace blood
· Prevent complications
Types
· Red blood cell transfusion
· Plasma transfusion
· Platelet transfusion
· Whole blood transfusion
· Exchange blood transfusion
Requirements
1. A tray containing the following:
· Blood giving set
· Intravenous infusion (0.9 % Normal Saline)
· Sterile gloves
· Examination gloves
· Blood in a warmer
· Gallipot
· Receiver for soiled swabs
· Hydrocortisone
· Syringes (2cc)
2. Vital signs tray
· Cotton wool swabs
· Methylated spirit
· Savlon solution
· Thermometer
· Sphygmomanometer (manual/electronic)
· Pulse oximeter
· Pain scale (appropriate)
3. Blanket or extra sheet
4. Drip stand
5. Blood bank issue slip
6. Informed consent slip/document
7. Patient chart: Vital signs chart, Nurses Notes and treatment Chart
8. Appropriate prescribed pre-medication (if any)
9. Intake and output chart
Steps
1. Establish rapport (refer steps)
2. Explain procedure to child or caregiver/family (refer steps)
3. Allow caregiver to take a decision of either staying or leaving the resuscitation area
4. Provide privacy
5. Perform hand hygiene
6. Disinfect and set tray for blood administration
7. Confirm child’s details with the chart or caregiver
8. Confirm blood details with a colleague to ensure that you are giving the right blood to the right child
9. Check vital signs and records signs and symptoms of heart failure
10. Put on examination gloves
11. Check existing line for leakage or patency
12. Set IV line if not available
13. Give prescribed pre-medication (if necessary)
14. Administer blood through appropriate filter to eliminate particles in the blood
15. Record start time of transfusion
16. Administer blood slower than the prescribed flow rate and stay with the child for the first 15 minutes for any immediate transfusion reaction
17. Stop transfusion immediately if any adverse reactions are observed and set up normal saline
18. Manage adverse reactions appropriately and call for help 19. Check vital signs after 15 minutes, if stable the rate can be increased to the prescribed rate
19. Assess child every 30 minutes throughout the blood transfusion until completion
20. Reassure child and caregiver throughout the procedure
21. Repeat vital signs 15 minutes after completion and document
22. Observe for any post transfusion reaction and report
23. Congratulate child and caregiver for their cooperation
24. Dispose off and decontaminate used items
25. Document procedure on appropriate charts
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