Overview
This lecture demonstrates the steps for safely administering a blood transfusion, including preparation, verification, setup, monitoring, and handling potential transfusion reactions.
Pre-Transfusion Preparation
- Ask the patient about previous transfusion reactions.
- Ensure the patient has a patent (working) IV site.
- Confirm there is a signed informed consent in the patient's chart.
- Gather supplies: blood administration Y tubing and normal saline for priming.
- Prime the tubing with normal saline only, never with other fluids.
- Connect the primed tubing to the patient's IV and have it ready before retrieving blood.
Blood Verification & Setup
- Retrieve blood from the blood bank and visually inspect it for correct color, consistency, and intact bag.
- Two registered nurses must verify: patient identity, blood type, blood unit number, birth date, and cross-matching documentation.
- Both nurses sign and initial verification documentation.
- Take and document the patient's initial vital signs before transfusion begins.
Administering the Transfusion
- Hang the blood bag and spike it to the blood administration tubing.
- Clamp the saline line when administering blood to prevent backflow.
- Use the pump to flush out the saline and fill the tubing with blood before starting the official transfusion.
- Blood transfusion must begin within 30 minutes of receiving blood from the lab, and finish within 4 hours.
- Official transfusion start time is when blood reaches the patient.
Monitoring and Managing Reactions
- Stay with the patient for the first 15 minutes to monitor for transfusion reactions.
- If a reaction occurs, stop the blood infusion immediately and administer normal saline through a separate line.
- Disconnect and send all blood products and tubing back to the lab for analysis if a reaction occurs.
- Take a second set of vital signs after 15 minutes if no reaction has occurred.
Key Terms & Definitions
- Blood transfusion — administration of donated blood products to a patient via IV.
- Y tubing — specialized tubing with two arms for blood and saline, used for transfusions.
- Cross-matching — lab process to ensure compatibility between donor blood and recipient.
- Transfusion reaction — adverse response by the patient’s body to transfused blood.
Action Items / Next Steps
- Document all verifications, vital signs, and responses in the patient's chart.
- Remain with the patient for at least the first 15 minutes of the transfusion.
- Send all materials back to the lab if a transfusion reaction occurs.