Commonly Transfused Blood Products and Blood Components

General
Consideration
s:
Wear gloves and face shield when working with blood products; ideally a 20g or larger IV catheter is preferred unless the patient is
very young or very old and has smaller veins; use normal saline only between transfusions and to keep the vein open if there is a
reaction; hang and start blood infusion within 30 minutes of obtaining blood from the blood bank; remain with the patient and
assess vital signs/patient complaints during the rst !" minutes of the transfusion# If no signs of a reaction$ ad%ust &ow to ordered
rate or as fast as patient's circulatory system can tolerate#
SYMPTOMS OF A TRANSFS!ON R"ACT!ON: &ushing$ feverish feeling$ chills$ nausea$ low back pain and headache
OT#"R SYMPTOMS: palpitations (usually when hypotension is present); di*culty swallowing or breathing (possible
anaphyla+is); tingling of ngers$ muscle cramps$ vomiting$ faintness (hypotension$ arrhythmia$ hypocalcemia); muscle
weakness$ irritability$ bradycardia (hyperkalemia when large volumes of older stored blood is transfused)
Component $%at&s in it $%y use it Administration'Nursin( Considerations
$%ole Blood
one unit contains "00 m, of all
blood components- ./0s$
W/0s$ plasma$ platelets$
clotting factors (some
clotting factors are not viable
after 21 hours of storage)
Increases blood volume and
o+ygen carrying capacity after
hemorrhage
must be 2/3 and .h compatible
one unit must be infused within a 14hour time period
use a 54type blood administration set with lter (to remove
microaggregates of degenerating platelets and brin
strands)
one unit increases 6gb by ! gm/d,
Pac)ed Red
Blood Cells
*RBCs+
one unit contains 2"0 m, of
whole blood (./0s$ W/0s$
platelets and plasma) with
708 of the plasma removed
Increases red blood cell mass and
o+ygen carrying capacity in
chronic anemia not due to
nutritional or drug therapy and
other bleeding conditions
$%ite Blood
Cells *$BCs+
one unit contains !"0 m, of
W/0s or leukocytes
suspended in 208 of the
plasma
9epsis that has been
unresponsive to antibiotics
with positive blood cultures$
persistent fever$ and
granulocytopenia
must be 2/3 and .h compatible
can use a straight4line or component drip IV administration
set with an in4line blood lter
periodically agitate the bag of cells to prevent the W/0s
from settling and to prevent accidental bolus of white
blood cells
fever and chills in the patient is an e+pected occurrence
may reduce &ow rate per :; order for patient comfort if
fever and chills occur
give antipyretics or premedicate with /enadryl if ordered
Platelets
one unit contains 3" to "0 m, of
platelet sediment from ./0s
or plasma$ may have small
numbers of ./0s and W/0s
blood bank may pool up to 7
units for one infusion
/leeding due to
thrombocytopenia$ decreased
platelet counts or presence of
abnormal platelets; leukemia;
aplastic anemia; ;I0; post4
transfusion thrombocytopenia
must be 2/3 compatible when possible and .h compatible is
preferred
use a ltered component drip administration set
infuse at rate of !00m, per !" minutes
should not be given if patient has a fever
platelet count should be drawn ! to 3 hours after platelet
transfusion
Fres% Fro,en
Plasma
*FFP+
one unit contains 200 to 2"0 m,
of plasma and all clotting
factors
/leeding$ coagulation factor
deciencies$ Warfarin reversal$
thrombotic thrombocytopenic
purpura
must be 2/3 compatible; .h match is not re<uired
use a straight4line IV administration set
infuse rapidly
hypocalcemia can occur with multiple transfusions of ==>
due to presence of citric acid in the ==> which binds
serum calcium
-. Al/umin
*/u0ered
one unit of "8 2lbumin contains
!2#" grams of albumin in 2"0
m,
.eplaces volume lost by shock in
burns$ trauma$ surgery or
infections; hypoproteinemia
2/3/.h compatibility is NOT necessary
manufacturer usually supplies the administration set you
should use
saline+
12. Al/umin
*salt poor+
one unit of !08 2lbumin
contains !2#" grams of
albumin in "0 m,
rate and volume infused dictated by patients response
watch for circulatory overload in patients with cardiac or
pulmonary disease