Blood Transfusion: Key Concepts, Procedures, and Complications in Healthcare

What does blood transfusion refer to?

The transfer of whole blood or its components, including packed red blood cells (PRBC), platelets, plasma (FFP), and albumin.

What is required before a blood transfusion?

Informed consent, unless it is life-saving.

What key assessments should be made before a transfusion?

Cultural beliefs, history of transfusion reactions, baseline vital signs and lab values, patient ID confirmation, blood type matching, IV site check, and priming tubing with 0.9% NS.

What are some cultural challenges to consider before a blood transfusion?

Religious beliefs, cultural perceptions of blood, language barriers, mistrust of the healthcare system, and gender/family decision-making.

How soon should a blood transfusion be started after obtaining blood?

Within 30 minutes.

What should be monitored during a blood transfusion?

Vital signs per protocol and patient responses such as chills, fever, dizziness, and dyspnea.

What should be done if a transfusion reaction is suspected?

Stop the transfusion immediately and keep the IV line open with a new NS bag.

What is the maximum time to complete a blood transfusion?

Complete infusion within 4 hours.

What are the key components to check before administering blood?

Patient's name, Medical Record #, Unit #, blood component, Group & Rh factor, donor number, and expiration date.

What is an acute hemolytic reaction?

A life-threatening emergency caused by incompatibility between donor and recipient blood, characterized by fever, hypotension, tachycardia, chills, dyspnea, and renal failure.

What are common symptoms of a febrile nonhemolytic reaction?

Sudden shaking (rigors), fever, headache, flushing, anxiety, and muscle aches.

What nursing actions should be taken during a transfusion reaction?

Stop the transfusion, monitor cardiac status, notify the primary healthcare provider, and prepare to administer emergency medications.

What is the significance of checking blood product identification?

Improper product-to-patient identification causes 90% of hemolytic transfusion reactions.

What is the recommended infusion rate initially for blood transfusion?

Infuse slowly at 25-50 ml/hr until patient status is confirmed stable.

What should be done with blood bags and tubing after a transfusion?

Dispose of them in biohazard waste.

What is the importance of priming the tubing with 0.9% NS?

It prevents hemolysis.

What are the potential complications of blood transfusions?

Acute hemolytic reaction, febrile nonhemolytic reaction, mild allergic reaction, anaphylactic reaction, circulatory overload or TRALI, and sepsis.

What is the protocol for monitoring vital signs during a transfusion?

Check vital signs 15 minutes after starting the transfusion, then every hour if stable.

What should be done if a patient refuses blood products?

Respect the patient's decision and assess cultural beliefs.

What is the role of two nurses in the transfusion process?

Two nurses must check and sign the transfusion requisition and blood bag at the bedside.

What is the purpose of gently inverting the blood unit before administration?

To mix the cells.

What is the recommended IV gauge for blood transfusions?

18-22G; 16-18G for rapid infusion.