BT

• Blood transfusion


  Introduction of whole blood or blood components into the venous circulation

  
• Blood typing


  Determines the presence of the ABO and Rh antigens
• Crossmatching


  Identify possible interactions of minor antigens with corresponding antibodies
• Whole blood


  • Most commonly used in instances of acute massive blood loss or extreme cases of acute hemorrhage
  • Replaces blood volume and all blood products such as RBCs, Plasma, plasma proteins, fresh platelets, and other clotting factor
• Packed RBC


  • Make up the blood product remaining after up to 80% of the plasma is removed from the whole blood
  • Used to increase the oxygen-carrying capacity of blood in anemias, surgery, and disorders with slow bleeding
• Autologous red blood cells


  • Are those in which the patient is infused with his or her own blood, which was donated in advance
  • Used for blood replacement following planned elective surgery

  
• Platelets


  • Replaces platelets in clients with bleeding disorders or platelet deficiency
• Fresh frozen plasma


  • Expands blood volume and provides clotting factors
• Albumin / plasma protein

  • Blood volume expander
  • Provides plasma proteins
• Cryoprecipitate


  • Used for clients with clotting factor deficiencies
• Plasma protein factor


  • Portion of the plasma remaining after fibrinogen, a protein important in blood clotting, and globulin, a simple protein found in blood serum, have been removed
• Nursing responsibilities (continued)

  1. Informed consent

  2. Baseline VS

  3. Blood from blood bank

  4. Cross matching and blood typing

  5. Practice strict asepsis
• Nursing responsibilities (continued)

  1. At least 2 nurses check the label of blood transfusion

  2. Serial number

  3. Blood component

  4. Blood type

  5. Rh factor

  6. Expiration date

  7. Screening tests: (VDRL – STD's, HBsAg – Hep B, Malarial smear)

  
• Nursing responsibilities (continued)


  1. Warm blood at room temperature before transfusion

  2. Identify client properly

  3. Use needle gauge 18 -20

  4. Use BT (blood transfusion) set with filter

  5. Start infusion slowly at 10 gtts/min

  6. Remain at the bedside for 15-30 minutes

  
• Nursing responsibilities (continued)

  1. Administer 0.9% NaCl before, during, and after BT

  2. Never administer IV fluids with dextrose

  3. Administer Blood Transfusion for 4 hours (whole blood, Packed RBC)

  4. For plasma, platelets, cryoprecipitate, transfuse quickly (20 min)

  5. Observe potential complications

  6. Notify Physician

  
• Nursing responsibilities for complications

  1. Stop BT immediately

  2. Start IV line 0.9 NaCl

  3. Collect urine specimen

  4. Monitor VS

  5. Send unused blood and BT set to the blood bank

  6. Administer Antihistamine, Diuretics and Bronchodilators as ordered

  7. Documentation

  
• Dextrose causes Hemolysis
• Clotting factors can easily be destroyed