POSTPARTUM HEMORRHAGE BLOOD TYPES

Postpartum hemorrhage (also called PPH) is • When you get a transfusion, the blood you're
when a woman has heavy bleeding after giving given has to work with the type of blood you have
birth. It usually happens within 1 day of giving birth, (either A, B, AB, or O). Otherwise, antibodies in
but it can happen up to 12 weeks after having a your own blood will attack it, and cause problems.
baby. About 1 to 5 in 100 women who have a baby That's why blood banks screen for blood type, Rh-
(1 to 5 percent) have ppH. factor (positive or negative), as well as anything
that can cause infection.
Women usually lose about half a quart (500
milliliters) during vaginal birth or about 1 quart • About 40% of people have type O blood, which is
(1,000 milliliters) after a cesarean birth. With safe to give almost anyone in a transfusion. If you
PPH, you can lose much more blood, which is have type O blood, you're called a universal
what makes it a dangerous condition. PPH can donor.
cause a severe drop in blood pressure. If not
treated quickly, this can lead to shock and death. • If you have type AB blood, you can receive any
type of blood and you're called a universal
BLOOD TRANSFUSION recipient. If you have Rh-negative blood, you can
only receive Rh-negative blood.
• A blood transfusion is a common, safe
medical procedure in which healthy blood TYPES OF BLOOD TRANSFUSIONS
is given to you through an intravenous (IV)
There are several common kinds of blood cell
line that has been inserted in one of your There are several common kinds of blood
transfusions:
blood vessels. cell transfusions:
• To administer a blood transfusion, • A• red blood cell transfusion may bemay
usedbe
if you have
A red blood cell transfusion used if
healthcare professionals place a thin anemia or an iron deficiency.
you have anemia or an iron deficiency.
needle into a vein-usually located in the
arm or hand-which allows blood to move • Platelets
• Plateletsareare
tinytiny
cellscells
in theinblood that help
the blood thatyouhelp
from a bag, through a rubber tube, and into stop bleeding. A platelet transfusion is
you stop bleeding. A platelet transfusion is used if your
the patient's vein through the needle. body
useddoesn't
if yourhave
bodyenough
doesn't of have
them,enough
possiblyofbecause
them,
Nurses must closely monitor their patient's ofpossibly
cancer or cancer
becausetreatments.
of cancer or cancer
vital signs throughout this procedure. treatments.
• A plasma transfusion helps replace the proteins in
WHAT ARE THE BLOOD COMPONENTS? • A
your plasma
blood transfusion
that help helps
it clot. It may replace
be needed afterthe
proteins
severe in your blood that help it clot. It may be
bleeding
• Cryoprecipitate: Helps your blood clot.
needed after severe bleeding
• Plasma: Carries nutrients your body needs.
• Platelets: Help your blood clot.
• Red blood cells: Carry oxygen throughout your WHAT ARE BLOOD TRANSFUSION
body. RISKS?

WHY WOULD YOU NEED A BLOOD 1. INFECTION

✓ In the past, infections were the biggest risk
TRANSFUSION?
of blood transfusions. But because of
• You've had major surgery or a serious today's screening and prevention
injury and you need to replace lost blood procedures, infections from blood
• You've experienced bleeding in your transfusions are very rare
digestive tract from an ulcer or other
condition
2. IRON OVERLOAD
• You have an illness like leukemia or kidney
✓ having enough iron in your body is
disease that causes anemia (not enough
important. iron plays a role in making your
healthy red blood cells)
muscles, nerves, and immune system
• You've received cancer treatments like
works well.
radiation or chemotherapy massive blood
lost during delivery.
3. ALLERGIC REACTION
✓ Usually happen during or soon after a
transfusion of blood components that
contain plasma.
✓ The patient’s body can react to protein in
plasma from donated blood
✓ Symptoms might be itching and hives,
other symptoms are wheezing and
shortness of breath
4. FEVER
✓ Some people suddenly get a fever or chills
during a blood transfusion or within a few
hours after the transfusion is over. A fever
is often a sign that the patient's body is
reacting to white blood cells, plasma, or
platelets in the donated blood.
5. ACUTE IMMUNE HEMOLYTIC REACTION
✓ A reaction is "hemolytic" when red blood
cells are destroyed.
✓ Happen when the blood type of the
component that is transfused into a patient
doesn't match the patient's blood type.
✓ Antibodies already present the in the
patient's blood attack the donated red
blood cells.
✓ Symptoms include fever, shills, dizziness,
pain in the lower back, dark urine and
breathing problems
6. DELAYED HEMOLYTIC REACTION
✓ This is similar to an acute immune
hemolytic reaction, but it happens more
gradually.
7. ANAPHYLACTIC REACTION
✓ This happens within minutes of starting a
transfusion and may be life-threatening.
You may experience swelling of the face
and throat, shortness of breath.
BEFORE STARTING THE PROCEDURE
1. CHECK THE DOCTOR'S ORDER
Sample:
- Transfuse 1 PRBC properly typed and
crossmatched
- Give paracetamol 500 mg 1 tab. 1 hour
prior to BT
- Give diphenhydramine 1 ampule TIVP 30
mins prior to BT
- WOF rashes, DOB, chills, fever and
itchiness
2. EDUCATE THE PATIENT
- Relay the signs and symptoms of a
transfusion reaction. If these occur, the
patient should notify the nurse
- Rash, itching, elevated temperature,
headache/ lower back pain, chills, increase
respiratory rate etc.
3. CONFIRM THEIR HEALTH HISTORY
ANY ALLERGIES
ONCE BLOOD IS AVAILABLE:
4. SECURE CONSENT FOR ADMINISTRATION
OF BLOOD PRODUCTS.
5. TWO RN'S MUST VERIFY THE FOLLOWING:
- Physician's order with patient identification
compared to the blood bank's
documentation
- Patient's name, date of birth
- Patient's blood type versus the donor's
blood type and Rh-factor compatibility
- Blood expiration date
- warm the blood
6. ASSESS AND DOCUMENT PATIENT
STATUS
- Take the vital signs, check urine output
7. WEAR GLOVES, OBTAIN LARGE BORE IV
ACCESS, USUALLY GAUGE 18.
REMEMBER: Normal saline solution is the only
solution that can be transfused with blood
products
START THE TRANSFUSION
8. Prepare the Y tubing with normal saline and
have the blood ready in an infusion pump
9. Run the blood slowly for the first 15 mins, 7-10
drops/min
10. Remain with the patient for the first 15 mins,
this is when most transfusion reactions can occur
11. Increase the rate of transfusion gradually after
this period, if your patient is stable and doesn't
display signs of transfusion reaction.
12. Document vital signs after 15 mins, then after
30mins, then hourly
 IF YOU SUSPECT A REACTION, DO THE
FOLLOWING:
A. Stop the transfusion IMMEDIATELY
B. Disconnect the blood tubing from the patient
C. Assess patients’ status
D. Notify the physician
E. Prepare for further doctor's orders
F. Continuously check the patient
G. Document everything

AFTER THE TRANSFUSION

1. Flush the Y tubing with normal saline
2. Dispose of used Y tubing in red biohazard bin.
3. Obtain post transfusion vital signs and
document the patient's status.