Blood Transfusion

 

Blood Transfusion

Classification

1.Whole blood transfusion:For the management of acute blood loss.

2.Plasma transfusion:For restoration of blood volume when it is necessary to increase the Hb level,and also to replace clotting factors.

3.Blood cell transfusion.

        .Red cell:For the treatment of anaemia.

       .Platelet:To correct bleeding disorder due to platelet deficiency.

       .Leukocyte:To help control serious infections,when here is deficiency of leukocytes.

4.Cryoprecipitate transfusion.

Indications

1.Acute severe blood loss due to any cause, such as the following.

               .Injury.

               .Accident.

               .Surgery.

               .Postdelivery(Postpartum haemorrhage).

               .Postabortion(postabortal).

               .Haematemesis.

               .From the surface   of a cancer.

      2.Chronic blood loss due to any cause,such as the following:

                .Peptic ulcer.

                .Ulcerative colitis.

                .Hemorrhoids.

                .Intestinal worms,e.g. hookworms.

3.Severe anaemia.

4.Septicemia.

5.Haemolytic disease.

6.Haematological disease of the neonate.

7.Burns.

8.Shock.

 

Selection of blood donor

Criterion	Features
Age	15 to 65 years.
Sex	Both male and female can donate blood.
Diseases	AIDS, hepatitis,sexually transmitted diseases, malaria,allergic diseases,and ischemic heart disease should not be present.
Haemoglobin	Should be in the normal range.
Time since previous donation	>3months.

 

Equipment

1.Screen.

2.Blood bottle or bag with anticoagulant like acid-citrate-dextrose.

3.Equipment as for intravenous injection.

4.Blood transfusion set.

5.Equipment to treat hypersensitivity reaction including shock.

 

Care before and after blood transfusion

1.There should be the doctor’s written order for the blood transfusion.

2.The patient’s blood group should be known.

3.Blood checked by the blood bank for diseases mentioned above,and grouped and cross matched with the patient’s blood should be used.

4.The information on the patient’s blood form and that on the bottle to be transfused is confirmed to be the same.

5.Unless the transfusion is urgent,the blood is kept on a clean flat surface for some  time so that its temperature gradually rises to the room temperature gradually rises to the room temperature.

6.If the transfusion is urgent, the blood is warmed by keeping the bottle in a bowl of warm water for some time.Overheating the blood is avoided as that may cause haemolysis.

7.The blood transfusion set and intravenous cannula are confirmed to be sterile.

8.The procedure is explained to the patient and his relatives.

9.The patient is asked to pass urine and/or stools if he has the desire,  so that he does not have to do that after starting the transfusion.

10.All medicines are given prior to the transfusion.

11.The patient’s temperature,pulse,respiration,and blood pressure are checked before starting the transfusion.

12.Some saline is infused first. Then the blood transfusion is started.

13.The rate of transfusion is kept slow in the beginning,and the patient’s temperature,pulse,respiration,and blood pressure are checked periodically for any adverse reaction.

14.If the patient develops any of the following reactions,the transfusion is stopped immediately is stopped immediately and the doctor is informed about it.

                  .Chills.

                  .Fever.

                  .Breathlessness.

                  .Lion pain.

                  .Constriction sensation  in the chest.

                  .Severe feeling ofapprehension.

15.The following points are checked periodically during the transfusion.

                    .Continuation of the drip of blood drops.

                    .Development of a swelling at the site of the transfusion due to extravasation of blood.                   

16.A record of the time of starting and ending the transfusion is made on the patient’s paper.

 

Reactions to blood transfusion

They are as shown in the following table:

Type	Features
Febrile rection	.Fever with/without chills.
Allergic reaction	.Redness of skin. .Skin rash. .Itching of skin. .Bronchospasm.
Anaphylactic reaction	.Anaphylactic shock.
Haemolytic reaction	.Haemoglobinuria. .Acute renal failure. .Anaemia. .Jaundice.
Circulatory overload	.Discomfort in chest. .Chest pain. .Breathlessness. .Congestive cardiac failure.
Transmission of diseases	.AIDS. .Hepatitis B. .Non-A non-Bhepatitis. .Malaria. .Sexually transmitted diseases.
Thrombophlebitis.	Red,tender veins.
Citrate intoxication	.Coagulopathy.
Potassium intoxication	.Cardiac arrest. .Weakness.
Haemosiderosis	.Fibrosis of liver. .Cirrhosis of liver. .Bronzing of skin.
Air embolism	.Breathlessness. .Sudden death.
Transfusion reaction	.Mismatched transfusion.