Component Task: Blood Transfusion

Blood transfusion is the infusion of whole blood or its fraction i.e. plasma, red blood cells (packed cells) into a patient’s vein. Whole blood is usually given when a patient’s total blood volume, cells or plasma drops below the normal values.

Aims

Therapeutic effects

Points to Note

·         There should be a written request for the blood transfusion

·         There must be a formal consent by the patient

·         The blood must be verified by two nurses or a nurse and a doctor/physician before transfusion

·         Check and double check the labels, the group, the number, rhesus factor, expiry date, compatibility, patient’s particulars against the appropriate document

·         Stop the transfusion immediately and inform the nurse in charge or the doctor when any reaction occurs

Observation

·         Check and record vital signs 4 hourly

·         Observe the for signs and symptoms of reaction throughout the transfusion.

Requirements

·         General requirement for administration of intravenous fluids

·         Blood giving set

·         Unit of blood or blood product

·         Pre-medication as ordered

·         Patient folder (Manual or Electronic)

Steps

1.        Establish rapport (Refer to steps)

2.      Explain procedure to the patient (Refer to steps)

3.      Obtain formal consent from the patient

4.      Perform hand hygiene

5.      Prepare trolley and send to the bedside

6.      Verify the following information with a colleague from the patient’s folder and label on the unit of blood or blood product:

·         Full name of patient

·         Ward

·         Blood group

·         Rhesus factor

·         Blood unit number

·         Expiry date

7.       Monitor vital signs and record

8.      Ensure cannula is in situ

9.      Protect the patient and bed with mackintosh and dressing towel

10.    Perform hand hygiene and wear sterile gloves

11.      Administer premedication if prescribed

12.    Insert the giving set into the pack, fill the chamber and expel air

13.    Tighten the clip on the giving set

14.    Insert the giving set into the cannula

15.    Regulate number of drops per minute accordingly

16.    Remove gloves and perform hand hygiene

17.    Record the amount of blood set up and the number of the unit on the fluid intake and output chart

18.    Continue to observe patient for any adverse reaction and report appropriately

19.    Dispose off used items and decontaminated

20.  Discuss findings with patient and relatives