This document provides information on various blood products including packed red blood cells, whole blood, platelets, fresh frozen plasma, albumin, and cryoprecipitate. It describes what each product is used to treat, how they are prepared and stored, typical volumes in each unit, and compatibility testing requirements. The document also outlines nursing considerations for blood transfusions such as obtaining a physician's order, explaining the procedure to the patient, preparing equipment, monitoring the patient during the transfusion, and intervening if any transfusion reactions occur.

1. Simon John L. Crisostomo, RN

2.  Packed RBC
 Replaces erythrocyte and resolution of anemia,
usually a unit of packed RBC’s are supplied in 250
ml unit bag
 Each unit increases the hemoglobin by 1 g/dl and
hct by 2-3% which will change in 4-6 hours after
completion of blood transfusion
 Whole Blood
 Rarelyused, used to resolve Hypovolemic shock
from Hemorrhage
 Each unit normally contain 500ml

3.  Platelets
 Used to treat Thrombocytopenia and Platelet
dysfunction
 Cross-matching is not required but may done, bags
contains 50-70 ml per unit to 200-400 ml per unit
 Administered immediately on receipt from blood
bank and may be given rapidly over 15 to 30 minutes

4.  Fresh Frozen Plasma
 Provides Clotting factors or Volume expansion; NO
PLATELETS
 Infused within 6 hours, Rh and ABO compatibility
test required
 About 200-250 ml per unit
 PT and PTT is a done post transfusion for resolution
of Coagulation defects or Hypovolemia

5.  Albumin
 Prepared in plasma and can stored for 5 year
 Treat Hypovolemic shock or Hypoalbunemia
 Cryoprecipitate
 Are prepared from Fresh Frozen Plasma and can be
stored for 1 year
 Used to replace clotting factors, especially Factor
VIII and Fibrinogen

6. Introduction of whole
blood plasma, serum
erythrocyte or platelets into
the venous circulation.

7.  1. To increase the circulating blood
volume as in shock due to hemorrhage.
 2. To increase red cell volume of
hemoglobin content of the blood as in
anemia.
 3. To increase WBC content of the blood
as in agranulocytosis and leukopenia.
 4. To increase the quantity of protein
malnutrition, excessive loss of protein
from burns or vesicular skin diseases.

8.  1. IV tray
 2. Compatible BT test
 3. IV catheter/needle g 18/19
 4. Plaster
 5. Tourniquet
 6. Blood product
 7. Plain NSS
 8. IV stand
 9. Gloves

9.  1. Verify doctor’s order -To avoid mistakes.
and make a treatment
card.
2. Explain procedure to - Encourage client’s coo-
client. peration and decrease
anxiety.
3. Request blood/blood
component from hospi-
tal blood bank to include
blood typing and cross
matching.

10.  4. Warm blood at - To prevent unto-
room temperature ward blood reac-
by wrapping the tion.
blood bag with a
towel. Blood should
be transfused not
more than 20 mins.
from the time it
arrives from the blood
bank.

11.  5. Have the doctor and To prevent any problem in relation
a nurse countercheck to transfusion.
the compatible blood
to be transfused.
a) name and identifica-
tion number
b) client’s blood group
and Rh type
c) donor’s blood group
and Rh type
d) crossmatch compati-
bility
e) blood unit and serial
component
f) expiration date of blood
product

12.  6. Get the base- - To compare any
line vital signs be- change in vital
fore transfusion. signs before and
during BT.
7. Give pre-med - To prevent minor
30 mins.before allergic reactions.
transfusion.

13.  8. Wash hands and - To preventcontami-
don gloves. nation of microor-
ganisms.
9. Prepare equipments - To facilitate inter-
needed. vention.

14.  Clients blood sample are drawn and
labelled at the bedside when drawn, the
client is asked to state his or her name,
which compared with the name of the
client’s identification band or bracelet.
 The recipient’s ABO and Rh type are
identified
 An Antibody screen is done to determine
the presence of antibodies other than anti-
A and Anti-B

15.  Cross-matching is done in which donor RBC are
combined with recipient’s serum and Coomb’s
serum; Crossmatching is compatible if NO RBC
Coagulation occurs
 The Universal RBC donor is O negative, The
Universal recipient is AB positive

16.  Infusion controllers and Pumps
 Usedto administer blood products if they are
designed to function with opaque soln’
 Special manual Pressure Cuff
 Maybe used to increase the flow rate but should
not exceed 300 mmHg

18.  To prevent HYPOTHERMIA and adverse
reactions when several units of blood being
administered
 Do not warm blood products in the
microwave or in hot water

20.  Avoid large vol. of refrigerated blood
infused rapidly which can cause cardiac
dysrhythmias
 No other soln’ other than NSS should be
added to blood components
 Medications are NEVER added to blood
components or piggy backed into a blood
transfusion
 Infusions (1 Unit) shout NOT exceed 4
hours to avoid Septicemia

21.  Blood administration set should be changed
every 4-6 hours
 Always check the blood bag for the
expiration date
 Inspect the blood bag for leaks, abnormal
color clots and bubbles
 Blood must be administered as soon as
possible (within 20-30 mins.) from receiving
from the blood bank
 Never refrigerate blood, if blood is
administered within 20-30 mins. Return it to
the blood bank

22.  Blood is infused as quickly as the clients
condition allows
 Components containing few RBC and Platelets
may be infused rapidly but caution must be
taken to avoid circulatory overload
 The nurse should measure the vital signs and
assess the lung sounds before the transfusion
and again after the 1st 15 mins and every hour
until 1 hour after the transfusion is completed

23.  Blood will be released from the Blood Bank
only by recognized personnel
 The Name and the identification number of
the intended recipient must be provided to
the blood bank and a documented
permanent record of this information must
be maintained
 Blood should be transported from the blood
bank to only one client at a time to prevent
blood delivery to the wrong patient

24.  The most critical phase of the transfusion is
Confirming product compatibility and
verifying clients identity
 Two registered nurses are needed to check
the physician’s order, the clients identity,
and the client’s identification band or
bracelet and number, verifying that the
name and number are identical to those on
the blood component bag

25.  At the bedside, the nurse ask the client to
state his or her name, the nurse compares
he name with the name on the
identification band or bracelet
 The nurse checks the blood bag tag, label,
blood requisition form to ensure that ABO
and Rh type are compatible
 If the nurse notes any unconsistencies when
verifying client identity and compatibility,
the nurse notifies the blood bank
immediately

26.  Assess for any cultural or religious beliefs
regarding blood transfusion (Jehovah’s
witness)
 Ensure that an Informed consent is signed
 Determine any previous reaction to blood
transfusion

27.  Check the clients VS, assess renal, circulatory and
respiratory status and the client’s ability to
tolerate intravenously administered fluids
 If the client’s temperature is elevated, notify the
physician before beginning the transfusion, a fever
may be a cause for delaying the transfusion in
addition to masking a possible symptoms of an
acute transfusion reaction

28.  Maintain standard, transmission based,
and other precautions as necessary
 Insert an IV line and infused normal
saline; maintain the infusion at KVO
 An 18 or 19 gauge IV needle will be
needed to achieved maximum flow rate of
blood products and prevent damage to
RBC; if a smaller gauge needle must be
used, RBC must be diluted with normal
saline

29.  Always check the bag for the volume of the
blood component
 Blood products should be infused through
administration set designed specifically for
blood; use a Y tubing or straight tubing
blood administration set that contains a filte
designed to trap fibrin clots and other debris
that accumulate during blood storage
 Premedicate the client with Acetaminophen
or Diphenylhydramine as prescribed if the
client has a history of adverse reactions 30
minutes before the transfusion is started if
orallly or immediately before transfusion if
IV administered

30.  Instruct the client to report anything unusual
immediately
 Determine the rate of infusion by physician
order
 Begin the transfusion slowly under close
supervision; if NO reaction is noted within
the 1st 15 mins. The flow can be increased to
the prescribed rate
 During the transfusion, monitor the client for
signs and symptoms of transfusion reaction,
the 1st 15 mins of the transfusion are the
most critical, and the nurse must stay with
the client

31.  If a major compatibility exist or a severe
allergic reaction occurs, the reaction is usually
evident within the 1st 50 ml of the transfusion
 Document the clients tolerance to the
administration of the blood products
 Monitor appropriate laboratory values and
document the effectiveness of treatment
related to the specific type of blood products

32.  If a transfusion reaction occurs, stop the
transfusion, the change in IV tubing down to the
IV site, keep the IV line open with normal
saline, notify the physician and blood bank and
return blood bag and tubing in the blood bank
 Do not leave the client alone and monitor the
client for nay life life threatening symptoms
 Obtain appropriate: laboratory samples, such as
blood and urine samples (free hemoglobin
indicates the RBC cell are hemolyzed)

34.  Signs: chills and diaphoresis, muscle aches,
back pain, or chest pain, rashes, hives,
itching swelling, rapid thready pulse,
dyspnea, cough, wheezing or rales, pallor,
cyanosis, apprehension, tingling and
numbness, headache, nauses, vomiting,
abdominal cramping and diarrhea
 Unsconscious client: weak pulse, fever,
tachycardia or bradycardia, hypotension,
visible hemoglobinuria, oliguria or anuria
 Delayed Transfusion reaction: occurring days
to years after a transfusion

35.  Nursing Interventions:
 Stop the transfusion
 Keep the intravenous line open with 0.9% normal
saline
 Notify the physician and the blood bank
 Remain with the client, observing signs and
symptoms and monitoring vital signs as often as
every 5 minutes
 Prepare to administer Emergency medications
such as antihistamines, vasopressors, fluids,
corticosteroids as prescribed
 Obtain urine specimen for laboratory studies
 Return blood bag, tubing attached labels,
transfusion record to the blood bank

36.  Signs: Cough, dyspnea, chest pain, and rales,
headache, hypertension and tachycardia and
a bounding pulse, distended neck veins
 Nursing Interventions:
 Slow the rate of Infusion
 Place the client in an Upright position, with the
feet in a dependent position
 Notify the physician
 Administer O2 diuretics, morphine, SO4 as
prescribed
 Monitor for dysrythmias
 Phlebotomy also may be a method of prescribed
treatment in a severe case

37.  Signs: Rapid onset of chills and a high fever
 Nursing Interventions:
 Notifythe physician
 Obtain blood cultures and cultures in the blood
bag
 Administer O2, IV fluids, antibiotics, vasopressors
and corticosteroids as ordered

38.  Signs: Vomiting, diarrhea, hypotension, altered
hematological values
 Nursing Interventions:
 Deferoxamine (Desferal) administered IV or SubQ,
removes accumulated iron via the kidneys
 Urine turns red as iron is excreted aa administration
of deferoxamine; treatment is discontinued when
serum iron level return to normal

39.  Signs: A disease commonly transmitted is
Hepatitis C which is manifested by
anorexia, nausea, vomiting, dark urine,
and jaundice; the symptoms usually occur
within 4-6 weeks after the transfusion
 Other infectious agents transmitted
include Hepatitis B virus, HIV, HHV6,
Epstein-Barr Virus, Human T-cell
Leukemia, Cytomegalovirus and Malaria
 Nursing Intervention:
 Donor screening
 Antibody testing of donors for HIV

40.  Description: Citrate is transfused, blood
binds with Calcium and is exercised
 Nursing Intervention
 Assess serum Calcium before and after the
transfusion
 Monitor for signs of Hypocalcemia
 Slow the transfusion
 Notify physician if signs og Hypocalcemia occurs

41.  Description: Stored blood liberates K+
through Hemodialysis
 Nursing Intervention:
 The older blood the greater risk of hyperkalemia;
therefore patient at risk such as those with renal
insufficiency or renal failure, should receive
fresh blood
 Assess the date on the blood and the serum
potassium level before and after the transfusion
and notify the physicians if signs of Hyperkalemia
occur