Blood Transfusions - Pharmacology Basics

Feb 15, 2025

Blood Transfusions

Overview

  • Review different blood types, who they can give to, and who they can receive from.
  • This information is critical and tested in exams like the NCLEX.

Types of Blood Products and Infusion Times

  • Packed Red Blood Cells (PRBCs)
    • Infusion time: 2 to 4 hours (max of 4 hours).
  • Fresh Frozen Plasma (FFP)
    • Infusion time: 15 to 30 minutes.
    • Must be administered within 2 hours of thawing.
  • Platelets
    • Infusion time: 15 to 30 minutes.

Blood Transfusion Protocol

  • Confirm patient’s ID, blood compatibility, and expiration date of the blood product with another RN.
  • Ensure patient has a 20-gauge or larger IV catheter (ideally an 18-gauge).
  • Check IV patency before ordering blood product.
  • Prime administration set with 0.9% NaCl (normal saline) only.
  • Do not administer medications through the blood line.
  • Blood must be returned to the blood bank if not used within 30 minutes of receipt.
  • Administer PRBCs within 4 hours.
  • Monitor patient vital signs before and during the first 15 minutes of transfusion.

Blood Transfusion Reactions

  • General Steps for Reaction
    • Stop the infusion immediately.
    • Administer 0.9% NaCl through a separate line.

Types of Reactions

  • Mild Allergic Reaction
    • Symptoms: Itching, flushing, urticaria.
    • Treatment: Diphenhydramine (Benadryl).
  • Anaphylactic Reaction
    • Symptoms: Wheezing, dyspnea, hypotension, decreased SpO2.
    • Treatment: Epinephrine, corticosteroids.
  • Febrile Reaction
    • Symptoms: Fever, chills, hypotension, tachycardia, tachypnea.
    • Treatment: Antipyretics.
  • Septic Reaction
    • Symptoms: Fever, chills, abdominal pain.
    • Treatment: Cultures, antibiotics.
  • Acute Hemolytic Reaction
    • Symptoms: Low back pain, fever, chills, tachycardia, tachypnea, hypotension.
    • Treatment: Labs, specimens, IV fluids.
  • Circulatory Overload Reaction
    • Symptoms: Dyspnea, tachycardia, tachypnea, crackles, hypertension, distended jugular veins.
    • Treatment: Slow infusion rate, monitor oxygenation, diuretics, raise head of the bed.

Quiz

  1. What do you use to prime the blood transfusion administration set?
    • Answer: 0.9% NaCl
  2. Low back pain, fever, tachycardia, and tachypnea are signs of what blood transfusion reaction?
    • Answer: Acute hemolytic reaction.
  3. A blood transfusion needs to be completed within blank hours.
    • Answer: Four hours.

Conclusion

  • This concludes the pharmacology basics video series.
  • Reminder to review and share the content if found helpful.