Blood Transfusion Procedure

Definition: It is the giving of blood to a patient through a vein

Purpose
• To counteract severe hemorrhage and replace the blood loss.
• To prevent circulatory failure in operation where blood loss is considerable, such as in rectal resection hysterectomy and arterial surgery.
• In severe burns to make up for blood lost by burning but only after plasma and electrolytes have been replaced.
• For treatment of severe anemia due to cancer, marrow aplasia and similar conditions.
• To provide clotting factors normally present in blood, which may be absent as a result of disease.

Equipment
• Bottle containing blood, with the patient name, blood group and Rh. Factor and expiry date.
• Blood giving set
• Sterile syringes and needle
• Alcohol swabs
• Sterile gauze
• Rubber sheet and towel
• Tourniquet
• Arm splint
• Bandages and scissors
• Adhesive tape
• Receiver for dirty swabs
• I.V pole (stand)
• Patient's chart.

Procedure
• Explain procedure to patient
• Before blood transfusion is administered, the nurse has to check the blood group & RH- factor if cross match of the donor's & the recipient’s blood is done and is compatible. And also check for HIV other blood born pathoges.
• Prepare the tray with necessary items
• Before taking it to the patient's room, check the patient's name, hospital number, bed number, blood group, Rh. Factor and the expiry date with a 2nd nurse or a doctor.
• Blood should be used within 21 days of its withdrawal date, if sodium citrate is used it can be used until 36 days.
• Take it to the pt's room
• Hang the bottle & remove the air from the tubing
• Put pt. in a comfortable position.
• Place rubber & towel under the arm
• Check the vital signs before administering
• Choose the vein
• Apply tourniquet
• Clean the skin & feel for a distended vein & clean again.
• Puncture the vein with the needle (the needle here should be short and wide so that it does not cause occlusion easily)
• After you make sure that you are in the vein release tourniquet & open the clamp.
• The drop/minute at the beginning should be very slow
• Watch patient closely for any reaction
• If there is no reaction from the patient regulate the rate of flow according to the patient's conditions & the order.
• Splint the arm & position it comfortably.
• Remove the equipment you have used, wash and return to its proper place.
• Record the time you started the blood & any other pertinent information.
• Check pt. frequently.

Note:
1. Always member to have anti- histamine injection ready in case a patient has reaction from the blood.
2. Be familiar with the most usual symptoms of blood reactions which are:

Immediate Reaction:
a) Headache
b) Backache
c) Chills
d) Pyrexia
e) Rash of the skin (urticaria )

Late Reaction
a) Dyspnea
b) Renal shut down in severe cases
c) Heamaturia
d) Chest pain
e) Rigor (rigidity)