What is the most comnmon side effect from donating blood?
Passing out from too much fluid volume change
In Packed Red Blood Cells what is removed?
Plasma, to make it 70% RBCs without increasing the volume
What blood product reverses the effects of Coumadin? If emergency surgery is needed this can be given so the surgery can be performed.
Fresh Frozen Plasma
Why are platelets transfused?
Only to replace platelets.
What are the general criteria for blood donation?
- 17 years old
- 110 lbs ( kg)
- No donations of Whole Blood within 8 weeks
- No fever, illness, No HIV risk factors,
Hgb levels <_____ must always have a transfusion.
Hgb levels >______rarely do.
1 unit of PRBCs will increase Hgb by how much?
What life threatening reaction to bllod transfusion comes from transfusiong the wrong blood type? The antigens of the wrong blood type will cause your own to attack and destroy RBs spilling into the gut. The free hgb will destroy the kidneys.
Acute Hemolytic reaction
What are the symptoms and prevention of Acute Hemolytic reaction?
- symptoms: occur within minutes fever, chills, lower back pain, chest tightening, dyspnea, anexity, hemoglobinuria
- prevention: give the right type
What is the risk for an allergic reaction to a blood transfusion and how is it treated?
The pt is allergic to something the donor encountered. Benedryl may ne given for itching
Reaction to blood transfusion where usually this is not the first time the pt has received blood. They can develop a fever only if the pt has antibodies to the donor blood.
Febrile (nonhemolytic) reaction
What is the most common transfusion problem? It occurs within 4 hours of transfusion.
Transfusion-related acute lung injury.
What is Transfusion-related acute lung injury?
What is the treatment?
- Pulmonary edema not from fluid overload (not cardiac), May have chills, fever, rattle in lungs.
- Treatment is the same as PE.
How do you prevent Fuild overlaod during bllod transfusion?
- Decrease the rate of administration.
- Give Lasix to pts at risk
Why doesn't D.H.R. overload the kidneys?
It is not as rapid.
What are the risk factors for Bacteremia?
How can it be prevented?
Bacteria from the donor skin getting into the blood, fingers fron the staff doing the procedure.
- Blood is stored in refridgerator so bacteria will grow slower.
- Transfusion must start 30 minutes from the removal from the blook bank
- It must be completely transfused in 4 hours, Toss the rest out.
- Don't transfer frothy blood
Hypothermia, Thrombocytopenia, coagulopathy, hypocalcemia and hyperkalemia are risks factors for what?
MASSIVE blood transfusions (replacing 1/2 to all of pt blood volume)
Why is hypothermia a problem with massive blood transfusions?
How can this be aleviated?
- The blood is cold.
- A blood warmer can be used while transfusing.
What is Coagulopathy?
How can it be treated?
- It's a problem with the clotting cascade because the patients own clotting factors have been dilted out.
- May need to give Fresh Frozen Plasma
When can hypocalcemia become a problem?
- In severe liver disease or
- More rapid infusion (quicker than 1 unit in 5 minutes)
How is Thrombocytopenia a problem in Massive blood transfusions?
Platelets deteriorate in the fridge and dilutes the patients own platelets
Hyperkalemia can be a problem with massive blood transfusions but it is rare. What causes this?
RBCs may deteriorate and spill into the gut. They contain Potassium causing hyperkalemia
What gauge IV needle is needed for blood transfusion?
At least a 20 gauge
Who prepares the transfusion documents and have to consent form signed?
What is 'type and hold'?
Check blood type and ensure it is available.
What is "cross and match"?
Holds that blood for the specific patient
What is the only fluid set up with Whole blood or PRBCs?
- Normal Saline
- Prime tubing with NS
- If blood thickens it can be thinned with a little NS
At what rate should the blood be transfused and how long should it take to infuse?
Slowly at first (50 ml/hr) then 125-150 ml/hr to finish between 2-4 hrs. After the first 15 minutes check on the patient every hour.
When should you immediately stop the transfusion?
- With s/s of hemolytic reaction.
- Temp increase of 2 degrees or greater and/or dyspnea, low back pain, dark urine.
What should you do for Fluid Volume Excess?
Slow the transfusion and call the doctor.