what does TACO stand for?
Transfusion associated cardiac overload
what does albumin do?
this increases the volume of blood
what is “Cellsaver blood”?
It salvages your blood and reuses it.
This process collects any blood lost, clean the blood and then can be reused to reinfuse the pt.
Why are blood transfusion mainly given during the day?
It is given during the day so should a reaction occur there are teams available to rapidly intervene.
how much is one unit of packed cells?
one unit of packed cells is 250mls
what do volume expanders do?
they increase fluid volume but don’t treat anaemia.
what is the pre-transfusion procedure?
prior to collection of a red cell pack from a blood fridge or transfusion service provider, you need to ensure that:
- the prescription/order is complete
- informed consent is documented/charted
- full explanation is given to the pt including potential reactions
- IV access (18-20g) is inserted and patent
- checked if any other IV medications are due (majority can’t be given with blood)
- baseline obs and assessment has been conducted
- are aware of the reason for transfusion
- resuscitation equipment, including O2 and adrenaline are available and in working order
- know pt hx/ co-morbidities/ previous transfusion hx
List the procedure when collecting a blood pack.
- fully completed and labelled request form
- self-access blood fridge/transfusion provider (check detail carefully/sign register)
- transport carefully -esky/cold bag
- direct to nurse requesting- (commencement within 30 mins of release from cold storage)
- unit must be infused within 4 hrs of release from storage
what should be checked when performing a transfusion and by how many nurses?
This check should be performed by 2 staff at the pt side.
- check correct pt ID/ correct documentation/ correct pack details
- check blood bag for any abdormalities
- check for any special requirements
- ID band essential/ still get pt to repeat details
- if in doubt don’t give it
- 1st hr should be performing obs every 15min, then 1 hrly
There are 2 main types of transfusion reactions, what are they?
- Febrile nonhaemolytic reaction (90% of all reactions are due to this)
- Acute haemolytic reaction - life threatening
List the clinical manifestations of a transfusion reaction?
- fever (greater than 1C rise in baseline T/above 38*C)
- rigors/chills
- urticaria
- tachycardia/hypotension (hypovolaemic shock)
- dyspnoea/wheezing (overload)
- nausea and vomiting
- back pain/ chest pain
- anxiety
- haemoglobinuria/oliguria
what would a nurse be doing at a pretransfusion assessment?
- pt health hx
- physical assessment
- monitoring temp
- giving a clear explanation of the need for transfusion
- pt has been explained potential reactions
- attaining consent
- ensuring correct IV access is inserted, patent and a PIVAS check has been performed
Whole blood donations are separated into their primary components. What are they?
- packed red blood cells (PRBCs)
- platelets
- plasma
what is preoperative autologus donation?
It is when the pt’s own blood is collected for future transfusion.
When should we perform a blood transfusion?
Only when the benefits outweigh the risks.
How long does a transfusion take?
Transfusions are generally over a 2-4hr period (as tolerated)
What is the nursing management if a transfusion reaction occurs?
- stop the transfusion immediately
- perform full set of obs
- provide emergency care and call for doctor (MET call if warranted)
- maintain IV access, however don’t flush line
- repeat all ID checks on blood products and pt
- notify RMO and transfusion service provider
- continue to monitor and record vitals as well as urine output (evidence of haemoblobinuria)
What is a pleural effusion?
A collection of fluid in the pleural space
What is emphysema?
A pleural effusion that contains pus. Basically an abscess within the lungs.
What are the clinical manifestations of pleural effusion?
- progressive dyspnoea
- decreased movement of the chest wall (lungs can’t expand)
- fever, night sweats
- cough
- weight loss
What is a flail chest?
It is the fracture of 2 or more ribs, in 2 or more separate locations, causing an unstable segment, usually involves anterior (sternal separation) or lateral rib fractures
