A. History of Blood Transfusion: The 1600 - 1700s

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 20

HandOut on Blood Transfusion

NCM 118 RLE


Prof. Ma. Susan Chan, MAN

BLOOD TRANSFUSION

A. History of Blood Transfusion (https://www.redcrossblood.org)

The 1600 - 1700s

1628
 British physician William Harvey discovers the circulation of blood. The first known
blood transfusion is attempted soon afterward.

1658
Microscopist Jan Swammerdam observes and describes red blood cells.

1665
The first recorded successful blood transfusion occurs in England: Physician Richard
Lower keeps dog alive by transfusing blood from other dogs.

1667
Jean-Baptiste Denis in France and Richard Lower and Edmund King in England
separately report successful transfusions from sheep to humans.

The 1800s

1818
British obstetrician James Blundell performs the first successful transfusion of human
blood to a patient for the treatment of postpartum hemorrhage.

1873-1880
U.S. physicians attempt transfusing milk from cows, goats and humans.

1884
Saline infusion replaces milk as a “blood substitute” due to the increased frequency
of adverse reactions to milk.

The 1900s

1901
Karl Landsteiner, an Austrian physician, discovers the first three human blood
groups.

1907

1
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

 Ludvig Hektoen suggests that the safety of transfusion might be improved by


cross-matching blood between donors and patients to exclude incompatible
mixtures.
 Reuben Ottenberg performs the first blood transfusion using blood typing and
cross-matching.

1914
Long-term anticoagulants, among them sodium citrate, are developed, allowing
longer preservation of blood.

1939-1940
The Rh blood group system is discovered by Karl Landsteiner, Alexander Wiener,
Philip Levine and R.E. Stetson.

1940

 The U.S. government establishes a national blood collection program.


 Edwin Cohn develops cold ethanol fractionation, the process of breaking
down plasma into components and products. Albumin, gamma globulin and
fibrinogen are isolated and become available for
clinical use.
 John Elliott develops the first blood
container, a vacuum bottle extensively used by
the Red Cross.
 Early blood processing program for relief of
English war victims, called Plasma for Britain,
begins under direction of Charles R. Drew,
MD.

1941

 The Red Cross begins National Blood Donor


Service to collect blood for the U.S. military with Dr. Charles R. Drew, formerly of
the Plasma for Britain program, as medical director.
 Soldiers injured during the Pearl Harbor attack are treated with albumin for
shock.

1944
Dried plasma becomes a vital element in the treatment of wounded soldiers during
World War II.

1945

 The Red Cross ends its World War II blood program for the military after
collecting more than 13 million pints.

2
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

 Robin Coombs, Arthur Mourant and Rob Race describe the use of anti-human
globulin to identify incomplete antibodies. The process became known as the
Coombs test, also known as the antiglobulin test.

1947
ABO blood-typing and syphilis testing is performed on each unit of blood.

1948
The Red Cross begins the first nationwide blood program for civilians by opening its
first collection center in Rochester, N.Y.

1949
The U.S. blood system is comprised of 1,500 hospital blood banks, 46 community
blood centers, and 31 American Red Cross regional blood centers.

1950

 Audrey Smith reports the use of glycerol cryoprotectant for red blood cells.
 The U.S. enters Korean War. Red Cross becomes blood collection agency for
military during Korean War.

1956
Establishment of national blood clearinghouse.

1957
The American Association of Blood Banks forms its committee on Inspection and
Accreditation to monitor the implementation of standards for blood banking.

1961
Platelet concentrates are recognized for reducing the mortality from hemorrhage in
cancer patients.

1964
Plasmapheresis is introduced as a means of collecting plasma for fractionation.

1967
American National Red Cross Board of Governors receives report that national
headquarters will host a national Rare Blood Donor Registry for blood types
occurring less than once in 200 people.

1969
S. Murphy and F. Gardner demonstrate the feasibility of storing platelets at room
temperature, revolutionizing platelet transfusion therapy.

3
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

1970
U.S. blood banks move toward an all-volunteer blood donor system.

1971
Hepatitis B surface antigen (HbsAg) testing of donated blood begins.

1972

 The Red Cross calls for national blood policy, which the federal government
sets up in 1974, supporting standardized practices and an end to paid
donations.
 Apheresis is used to extract one cellular component, returning the rest of the
blood to the donor.
 Food & Drug Administration (FDA) begins to regulate all 7,000 U.S. blood and
plasma centers.

1978
FDA requires blood bags to be labeled “paid” or “volunteer.”

1983

 Additive solutions extend shelf life of red blood cells to 42 days.


 The U.S. blood banking groups issue their first warning about Acquired
Immune Deficiency Syndrome (AIDS).

1985
Immediately after the Food and Drug Administration (FDA) licenses the first test to
detect the antibody to HIV on March 3, Red Cross Blood Services regions begin
testing all newly donated blood.

1987
The Red Cross opens its Holland Laboratory dedicated to biomedical research.

1992

 Testing of donor blood for HIV-1 and HIV-2 antibodies (anti-HIV-1 and anti-
HIV-2) is implemented.
 First National Testing Laboratory, applying standardized tests to ensure safety
of Red Cross blood products, opens in Dedham, Mass.

2000 to Present
2002
Nucleic acid amplification test (NAT) for HIV and hepatitis C virus (HCV) licensed by
the Food and Drug Administration.

B. Definition: What is a Blood Transfusion?


4
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

Blood transfusions are a potentially life-saving procedure that replaces blood lost
during surgery or injury. A blood transfusion can also serve as a treatment for
patients with illnesses that stifle their ability to naturally produce enough blood cells
for their bodies.

Blood transfusions are a routine medical procedure that delivers blood into a
patient’s body through a narrow tube that’s connected to a vein in their arm or hand.

To administer a blood transfusion, healthcare professionals place a thin needle into a


vein—usually located in the arm or hand—which allows blood to move from a bag,
through a rubber tube, and into the patient’s vein through the needle. Nurses must
closely monitor their patient’s vital signs throughout this procedure.

C. What are the four types of blood transfusions?

For people in critical condition, blood transfusions can be lifesaving. Four types of
blood products may be given through blood transfusions: 1. whole blood (FWB) , 2.
red blood cells (Packed RBC), 3. platelets, and 4. plasma. Most of the blood used
for transfusions comes from whole blood donations given by volunteer blood donors.
https://www.mayoclinic.org

Red blood cell transfusions may be given to patients who suffer from an iron
deficiency (i.e. anemia). This transfusion would boost a patient’s hemoglobin and
iron levels, while also improving oxygen levels in the body.

Platelet transfusions are often administered to patients who suffer from leukemia or
other types of cancer. This is because they may have lower platelet counts due to
chemotherapy treatments. Other patients may suffer from illnesses that stop the
body from creating enough platelets. Because of this, they may receive regular
transfusions in order to stay healthy.

Plasma transfusions provide vital proteins and other substances that are crucial to
a patient’s overall health. Plasma transfusions are often administered to those with
liver failure, severe infections, or serious burns.

D. What is the Purpose of a Blood Transfusion?


Common reasons for a blood transfusion:
 Many patients who undergo a major surgical procedure will receive a blood
transfusion to replace blood lost during surgery.

 Blood transfusions are typically administered to patients who have suffered


serious injuries from car crashes, natural disasters, or other traumatic
events.

5
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

 Patients who suffer from illnesses that cause anemia will typically require
blood transfusions as part of treatment. These can include illnesses such as
leukemia or kidney disease.

E. How Long Does it Take to Perform a Blood Transfusion?


Depending on the amount of blood a patient requires, a simple blood transfusion can
take anywhere from 1 to 4 hours.

The procedure starts when an intravenous (IV) line is placed into the patient’s body.
With this IV, the patient can receive new blood.

F. Who Performs a Blood Transfusion(BT)?

Blood transfusions can be performed by various healthcare professionals, such as


Registered Nurses (RNs). In the USA, the Licensed Vocational Nurses (LVNs) or
Licensed Practical Nurses (LPNs) is licensed to administer BT

Nurses will usually perform this task under the direction of a physician’s order.

G. Training Requirements for a Blood Transfusion

When it comes to blood transfusion requirements, most licensed professionals such


as Registered Nurses will typically learn how to perform blood transfusions through
educational programs and medical training.

In the Philippines, hospital conducts IV Training in coordination with Association Of


Nursing Service Administrators Of The Philippines (ANSAP)
Address. : #1 Diamond Street, Corner A Rodriguez Carmel V Subd. Tandang Sora
Q.C., Metro Manila.
Email: [email protected]
Tel. No.: (632) 366-1640
Fax No.: (632) 937-1001

In the United States of America (USA) , blood transfusion training is a significant


component of the NCLEX-RN exam. To pass this test and receive your nursing
license, you will be expected to demonstrate your knowledge of blood and blood
products (i.e. platelets, plasma, etc.).

Blood Transfusion Procedure


A Detailed Guide to Blood Transfusions

By reviewing the following steps, you can begin to learn more about the process of
blood transfusions. Each of you will be given a detailed checklist step by step
procedure lifted from ANSAP booklet 11th edition.

6
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

Like any other skill, blood transfusions require a lot of time and practice to master.
While in school, try not to feel disheartened if you don’t get it right the first time. And
don’t hesitate to ask for help.

Blood Transfusion Preparation

Blood transfusions are often administered in a hospital, outpatient clinic, or doctor’s


office. A nurse or doctor will also check the patient’s blood pressure, pulse, and
temperature before starting the procedure.

Blood Transfusion Steps

Here are some of the general guidelines you should follow when performing a
blood transfusion in a controlled setting.

Before the Transfusion


1. Find current type and crossmatch
 Take a blood sample, which will last up to 72 hours.
In the USA, blood letting is part of the RNs skills.
In the Philippines, Medical Technologists or Laboratory Techniciand
perform blood letting. Some physician ordered a complete blood

7
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

count along with the blood typing to save time and result is already
available.
 Send the blood sample to the blood bank
 Ensure the blood sample has the correct date/timing/labeling
 Wait for the blood bank to match and prepare needed units based on
the sample you sent them.

2. Obtain informed consent and health history


 Discuss the procedure with your patient
 Confirm their health history and any allergies
 Ensure that the supervising doctor has acquired signature consent for
administration of blood products from the patient

3. Obtain large bore IV access


 This is 18G or larger IV access
 Each unit will be transfused within 2-4 hours
 Obtain a second IV access if the patient requires additional IV
medication therapy (i.e. antibiotics)
 Remember: Normal saline is the only solution that can be transfused
with blood products

4. Assemble supplies
 Special Y tubing with an in-line filter
 0.9% NaCl (Normal Saline) solution
 Blood warmer

5. Obtain baseline vital signs


 These include heart rate, blood pressure, temperature, pulse oximeter,
and respiratory rate
 Lung sounds and accurate urine output should also be documented
(TRALI may occur, symptoms of TRALI typically develop during or within
6 hours of a transfusion. Patients present with rapid onset of dyspnea
and tachypnea, with an SpO2 < 90% on room air. There may be
associated fever, cyanosis and hypotension.)
 Notify the doctor if their temperature is greater than 100° F or 37.7 C

6. Obtain blood from blood bank

8
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

 Once the blood bank notifies you that the blood is ready, you must
schedule its delivery from the blood bank
 Packed red blood cells (pRBCs) can only be hung ONE UNIT AT A
TIME.
 Remember: Once the blood has been released for ther patient, youte
nurse have 20-30 minutes to start the transfusion and up to 4 hours to
complete the transfusion

Initiating the Blood Transfusion

1. Verify doctor’s written prescription and make a treatment card according to


hospital policy

Also Verify Blood Product


 Two RNs at the patient’s bedside must verify the following accurately:
a. Physician’s order with patient identification compared to the
blood bank’s documentation
b. Patient’s name, date of birth, and medical record number
c. Patient’s blood type versus the donor’s blood type and Rh-factor
compatibility
d. Blood expiration date

2. Observe ten (10) RIGHTS (Rs) when preparing and administering Intravenous
fluids and any blood or blood components this will ensure prudence and
safety in BT Administration.
 Educate the patient
 Relay the signs and symptoms of a transfusion reaction. If these occur,
the patient should notify their RN during the transfusion
 Rash, itching, elevated temperature, chest/back/headache,
chills, sweats, increased heart rate, increased respiratory rate,
decreased urine output, blood in urine, nausea, or vomiting

3. Explain the procedure/ rationale for giving blood transfusion to reassure


patient and significant others and secure consent. Get patient’s history
regarding previous transfusion. This is done for ethical and legal reasons.

4. Explain the importance of the benefits on Voluntary Blood Donation (RA 7719
– National Blood Service Act of 1994)

a. Republic Act No. 7719, also known as the National Blood Services Act of

9
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

1994, promotes voluntary blood donation to provide sufficient


supply of safe blood and to regulate blood banks. This act aims to
inculcate public awareness that blood donation is a humanitarian act.
b. .The benefits of giving blood:
b.1. Giving blood can reveal potential health problems
While it isn’t the same thing as a trip to the doctor, donating blood can be
another way to keep an eye on your cardiovascular health. You’ll receive
a mini-physical check up prior to the blood draw, in which someone will
check your pulse, blood pressure, body temperature, hemoglobin and
more.  This can sometimes shed light on issues you didn’t even know
about.
b.2. Giving blood can reduce harmful iron stores
Statistic shows that . 1:200. One in every two hundred people in the U.S.
is affected by a condition called hemochromatosis and most don’t even
know it.
Hemochromatosis is a disease that causes an iron overload and is
labeled as the most common genetic disease among Caucasians by
the Mayo Clinic.
The Centers for Disease Control and Prevention (CDC) says the removal
of red blood cells by phlebotomy (or donating blood) is the preferred
treatment for patients with excess iron in their blood.
b3. Giving blood may lower your risk of suffering a heart attack.
Donating blood at least once a year could reduce risk of a heart attack by
88 percent, according to a study conducted by the American Journal
of Epidemiology.* This relates to the iron issue again, says Dr. David
Dragoo, healthcare expert at Money Crashers.Dr. Dragoo explains that
high levels of iron in the blood constrict your blood vessels and create
more risk of a heart attack. Depleting those extra iron deposits by
donating blood gives your vessels more room to operate.
b.4. Giving blood may reduce your risk of developing cancer.
In an average, completely healthy person, the link between giving blood
and decreased cancer risk is slim. But research does support a reduced
risk of cancer for blood donors with different maladies, one of which is
hemochromatosis.
Phlebotomy (the process of drawing blood) was found to be an iron-
reduction method that is associated with lower cancer risk and mortality,
according to a study published by the Journal of the National Cancer
Institute. The study focused on patients affected by peripheral arterial
disease (PAD), which the Mayo Clinic describes as a common
circulatory problem. PAD patients who regularly donated blood had a
lower risk of developing cancer than those who did not.
b.5. Giving blood can help your liver stay healthy.
Another danger of iron overload is the health of your liver. “In recent
years, nonalcoholic fatty liver disease (NAFLD), the hepatic expression of

10
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

metabolic syndrome, has reached epidemic proportions,” reports


the National Center for Biotechnology Information.

Research has linked too much iron with NAFLD, Hepatitis C and other
liver diseases and infections. Though there are many other factors
involved in these problems, donating blood can help relieve some of
those iron stores and avoid extra issues in your liver.
b.6. Giving blood can help your mental state
While there are several physical benefits to donating blood, the most
powerful health benefit is arguably in the psychological realm. Donating
blood means that someone (or multiple people) somewhere will be getting
the help they desperately need.
Donating blood, especially on a regular basis, can be similar to volunteer
work. The person give of their time (and their literal blood) to help
strangers in need
This kind of regular, altruistic interaction has major psychological
benefits. Getting out of the usual environment to do something good for
someone else is stimulating in the best kind of way.  Volunteering has
been shown to have positive effects on happiness. In people over 65-
years-old, volunteering also reduces the risk of depression and
loneliness.

5. Request prescribe blood/blood components from blood bank to include blood


typing and X-matchmaking & blood result of transmissible Disease.
This ensures safety and accuracy.

6. Using a clean line tray, get compatible blood from hospital blood bank.

7. Wrap blood bag with clean towel & keep it at room temperature.

8. Have a doctor and a nurse assess patient’s condition. Countercheck the


compatible blood to be transfused against the X-matchmaking sheet noting
ABO grouping and RH, serial no. of each blood unit, and expiry date with the
blood bag label and other lab. Blood exam as required before transfusion
(Hgb & Hct.).

9. Get the baseline vital signs – BP, R, temperature before transfusion. Refer to
M.D. accordingly
Assess and document the patient’s status
 Baseline vital signs (HR, RR, Temp, SPO2, BP), lung sounds, urine
output, and color
10. Give pre-med 30 minutes before transfusion as prescribed.

11
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

11. Do hand hygiene before


and after the procedure

12. Prepare equipment


needed for BT (IV
injection tray,
compatible BT set, IV
Catheter / needle G
18/19, plaster,
tourniquet, blood
component to be
transfused, plain NSS
500 cc, IV set, g 18
needle (only if needed),
IV Hook, gloves, sterile
2x2 gauze or transparent dressing, etc.

The necessary Equipment for a Blood Transfusion

Suggested supplies for a blood transfusion may include the following:

 IV access. Blood components may be provided through a number of central


venous access devices (CVAD) or peripheral intravenous catheters. You
might want to consider the below sizes.
 20-22 gauge for routine transfusions in adults.
 16-18 gauge for rapid transfusions in adults.
 22-25 gauge for pediatrics.
 Administration sets. The requirements for these sets might vary. Check the
facility-specific policy first.
 Sets for blood components. Administering blood components requires the
use of a blood filter, which may range in pore size from 170 to 260 microns.
It’s intended to remove clots, cellular debris, and coagulated protein.
 Sets for PPPs. The administration of platelet-poor plasmas (PPPs) may
require a number of supplies, which often differ by product and brand.
Facilities should refer to the product monograph and local policy to
determine what filtration is required.
 Infusion devices. Infusion devices can be used to transfuse blood
components (i.e. infusion pumps, rapid infusers, blood warmers, and
pressure devices).
 Pressure infusion devices. A pressure infusion device may be used for the
rapid administration of blood components.
 Blood warmer devices. A blood warmer device is often used to prevent
hypothermia during rapid administration of cold-blood components, such as
the operating room or a trauma setting.

12
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

13. If main IVF is with dextrose 5% initiate an IV line with appropriate IV catheter
with plain NSS on another site, anchor catheter properly and regulate IV
drops.

14. Open compatible blood set aseptically and close roller clamp. Spike blood bag
carefully; fill the drip chamber at least half full; prime tubing band remove air
bubbles (if any). Use needle g 18 or 19 for side drip (for adults) or of 22 for
pedia (if blood is given through the Y injection port, the gauge of needle is
disregarded)

15. Disinfect the Y – injection port of IV tubing (plain NSS) and insert the needle
from BT administration set and secure with adhesive tape. ( Some hospitals
uses infusion pumps.

16. Close roller clamp of IV fluid of plain NSS and regulate to KVO while
transfusion is going on.

17. Transfuse the blood via the injection port to regulate at 10-15 gtts. Initially for
15 minutes and then at the prescribe rate (usually based on the patient’s
condition)

18. Observe patient for 10-15 minutes for any immediate reaction. Remain with
the patient at bedside for the first 15 minutes because this is when most
transfusion reactions can occur. After this 15 minutes period, the nurse may
increase the rate from KV0 to 2ml/min or 120ml per hour. if the patient is
stable and doesn’t display signs of a transfusion reaction

19. Observe patient on an on-going basis for any untoward signs and symptoms
such as flushed skin, chills, and elevated temperature, itchiness, urticarial,
and dyspnea. If any of this symptoms occurs stop the transfusion, , open
the roller clamp of the IV line with Plain NSS, and report to doctor
immediately

During the Transfusion


1. Look for any of these transfusion reactions
 Allergic
 Febrile
 GVHD (Graft vs. Host Disease)
 TRALI (Transfusion Related Acute Lung Injury)

2. If you suspect a reaction, do the following


 Stop the transfusion IMMEDIATELY
13
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

 Disconnect the blood tubing from the patient


 Stay with the patient and assess their status
 Continue to check for status changes every five minutes
 Notify the doctor and blood bank
 Prepare for further doctor’s orders
 Document everything

20. Swirl the bag hourly to mix the solid with the
plasma. N.B. one BT set that should be used
for 1-2 units of blood.

21. When blood is consumed, close the roller


clamp of BT, and disconnect from IV lines then regulate the IV of plain NSS
as prescribed.

22. Continue to observe the monitor patient post transfusion, for delayed reaction
could still occur Obtain post-transfusion vital signs and document the patient’s
status

23. Re-check Hgb and Gct, bleeding time, serial platelets count within specific
hours as prescribed & or per institution’s policy.

24. Discard blood bag and BT set and sharp according to Health Care Waste
Management (DOH/DENR). Dispose of used Y tubing in a red biohazard bin

25. Document the procedure, pertinent observations and nursing intervention and
endorse accordingly
 Document vital signs after 15 minutes, then hourly, and finally, at the
completion of the transfusion

26. Remind the doctor about administration of Calcium Gluconate if patient had
several units of blood transfusion (3-6 or more units of blood)
Why do we give calcium gluconate after blood transfusion?
Hypocalcemia - an adverse effect of massive blood transfusion examined.
The potential for hypocalcemia among patients receiving large amounts of
donated blood products over a short time period is due to the presence of the
anticoagulant citrate in the bag that donated blood is collected to. Citrate –
acts as anticoagulant by chelating calcium.

Blood Transfusion Recovery

14
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

After the procedure, patients may experience some soreness near the puncture site,
but this side effect should dissipate quickly. In addition, the patient’s doctor might
request a checkup after the transfusion.

Potential Risks or Complications of a Blood Transfusion

While this is typically a low-risk procedure, serious blood transfusion risks or


complications can include some of the following conditions:

 Allergic reactions
 Fever
 Acute immune hemolytic reaction
 Blood-borne infections

However, the most common reaction to a blood transfusion is mild soreness around
the IV site.

You can avoid some of these adverse reactions by following the appropriate steps.
What they say is true: practice makes perfect.

Tips for Mastering the Art of Blood Transfusions https://www.unitekcollege.edu

15
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

Many of our pro blood transfusion tips involve organization, patience, and a detail-
oriented nature. Here are a few pro blood transfusion tips from Dr. Siegel that may
assist you in the future.

 Ordering the wrong dose of platelets. There are two different kinds of
platelet products, and some hospitals offer both kinds. Because of this, ordering
platelets by the unit can create confusion about how much is needed. To avoid
this confusion, some clinicians order platelets by the dose.

 Ordering plasma to correct a high international normalized ratio (INR).


The INR of fresh frozen plasma is not 1.0 as one might assume. It is not
necessarily 1.1 or 1.2 or 1.3 either. Plasma can have an INR as high as 1.6. The
nurse should be careful because if plasma is given to a patient who as an INR of
1.4 or 1.5, that could make the INR worse.

The higher your PT or INR, the longer your blood takes to clot. An elevated PT or
INR means your blood is taking longer to clot than your healthcare provider
believes is healthy for you. When your PT or INR is too high, you have
an increased risk of bleeding

 Assuming leukoreduction protects immunocompromised patients.


Leukoreduction eliminates enough white cells to lessen the incidence of febrile
transfusion reactions, HLA antigen sensitization to the patients, and transmission
of cytomegalovirus infection. However, cellular blood products can still cause
transfusion-associated graft-versus-host disease. This means that
immunosuppressed patients may require additional precautions (i.e. the blood
may also needs to be irradiated).

The human leukocyte antigen (HLA) system (the major histocompatibility


complex [MHC] in humans) is an important part of the immune system and is
controlled by genes located on chromosome 6. It encodes cell surface molecules
specialized to present antigenic peptides to the T-cell receptor (TCR) on T cells.

 Being impatient with the blood typing and screening process. If the
patient’s blood has a positive antibody screen, the overall process can be much
lengthier. Once the antibodies are identified, and blood lacking the corresponding
antigens is found, the donor blood will also have to be physically cross-matched
with the patient’s sample. The process can take some time for blood-bank staff to
complete.

Why Should Nurses Learn How to Perform a Blood Transfusion?


Around the world, millions of patients need blood transfusions to survive. This
medical intervention requires knowledge and skill. Many studies have been
conducted on the awareness of nurses and physicians about blood transfusion. It

16
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

has even been noted there’s an increasing demand for blood transfusions in


hospitals.

As the nurse carrying out a doctor’s order, you will be responsible for prepping the
patient and ensuring appropriate history, lab work, documentation, and supplies are
available before the transfusion. These crucial steps can help prevent adverse
transfusion reactions.

In the nursing field, you never know when you may encounter life-or-death situations.
Reflect on your goals and which specialization is best for you. Ensure that you work
in a facility that suits your needs. And, of course, make sure you pick the right
school.

17
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

DIFFERENT INTRAVENOUS SITES

18
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

19
HandOut on Blood Transfusion
NCM 118 RLE
Prof. Ma. Susan Chan, MAN

20

You might also like