What guage of needle do you use to administer blood?
20 guage
What type of tubing do you used to administer blood?
Y Tubing
What type of fluid do you prime your tubing with when administer blood?
NS
When do you take and check a patient VS when administering blood?
- Pre transfusion
- 15 minutes after starting
- AFter the transfusion
How long do you remain with the patient when administering blood?
The first 15 minutes
What is the proper rate when infusing blood?
2mL/min for the first 15 minutes
PRBC (Packed RBC 2-4 hours)
Platlets and FFP (Fresh frozen plasma) 15-30 minutes
If you notice a transfusion rxn , what do you do?
- Stop the transfusion
- Maintain a patent IV line with saline- draw back as much blood as you can to clear the line
- Notify the blood bank and HCP immediately
- Recheck the product-to-patient identification
- Monitor vitals and output- q 15 minutes for the first hour, q 30 minutes for the second hour and then hourly.
- Treat symptoms as per doctor order
- Save the blood bag, tubing, and send it back to the blood bank.
What is the most common type of blood transfusion reaction?
Acute hemolytic because of incompatatble blood.
-Chills, fever, flushing. low back pain, high HR, high RR (metabolic acidosis ), low BP, dark urine
What is a febrile blood transfusion reaction
leukocyte incompatiblity.
- Sudden chills and fever, flushing and headache
- prevent by giving leukocyte-depleted products
- may premedicate with tylenol and benadryl 30 minutes before transfuison
What does an allergic rxn to a blood transfusion look like ?
Mild vs Severe
Pt has a sensitivity to the donors plasma proteins
- flushing, itching, hives, wheezing, dyspnea,
- premedicate with benedryl
- if mild rxn you can restart transfusion at a slower rate
- if severe give epinephrine and corticosteroids.
What is a circulatory overload transfusion rxn?
- Cough, dyspnea, HTN, high HR, distended neck veins
- Give diuretics, oxygen, morphine (vasodilate)
When does sepsis occur with a blood transfusion rxn?
Happens when blood products are improperly handeled.
What is TRALI?
Transfusion-related acute lung injury
- Caused by an antibody rxn
- Sudden development of noncardiogenic pulmonary edema within 2-6 hours after transfusion. This can lead to death
What is a massive blood transfusion reaction?
Occurs if the entire blood volume is being replaced within 24 hours.
-Its caused because of an imbalance of clotting factors, albumin, and platlets. Pt is also at risk for electrolyte imbalances.
What is a delyated transfusion rxn?
Hemolytic
Infection
Iron overload
