Handout on Blood Transfusion NOM 118 RLE Prof, Ma, Susan Chan, MAN BLOOD TRANSFUSION A. History of Blood Transfusion (hitps:/iwmw 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 hemorthage. 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 1904 Karl Landsteiner, an Austrian physician, discovers the first three human blood groups.HandOut on Blood Transfusion NOM 118 RLE Prof, Ma. Susan Chan, MAN, 1907 + 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 RE. 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 Eliott 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 Brita 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HandOut on Blood Transfusion NOM 118 RLE Prof. Ma, Susan Chan, MAN Dried plasma becomes a vital element in the treatment of wounded soldiers during World War I 1945 + The Red Cross ends its World War Il blood program for the military after collecting more than 13 million pints. + 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. 1967 ‘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 hemorthage in ‘cancer patients. 1964HandOut on Blood Transfusion NOM 118 RLE Prof. Ma. Susan Chan, MAN, 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. 1970 U.S. blood banks move toward an all-volunteer blood donor system. 1974 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HandOut on Blood Transfusion NCM 118 RLE Prof. Ma, Susan Chan, MAN 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? 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 vvein—usually located in the arm or hand—which allows blood to move from @ 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. htlos:sAwww mayociinic.org Red blood cell transfusions may be given to patients who suffer from an iron deficiency (ie. 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 5HandOut on Blood Transfusion NOM 118 RLE Prof, Ma, Susan Chan, MAN 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 transfusio + 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. + 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 4 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HandOut on Blood Transfusion NCM 118 RLE Prof. Ma, Susan Chan, MAN Email: secretariat.ansapinc@gmail.com 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 (ie. 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 11* edition. 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HandOut on Blood Transfusion NOM 118 RLE Prof, Ma, Susan Chan, MAN 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 Technicians perform blood letting. Some physician ordered a complete blood ‘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 datefiming/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 (ie. 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 fiter = 0.9% NaCl (Normal Saline) solution + Blood warmerHandOut on Blood Transfusion NCM 118 RLE Prof. Ma, Susan Chan, MAN 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 + 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 41. Check and Verify doctor's written prescription and make a treatment card according to hospital policy Also Verity Blood Product + Two RNs at the patient's bedside must verify the following accurately: Physician's order with patient identification compared to the blood bank's documentation Patient's name, date of birth, and medical record number, room number c. Patient's blood type versus the donor's blood type and Rh-factor ‘compatibility 4 Blood expiration date 2. Observe ten (1) 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HandOut on Blood Transfusion NOM 118 RLE Prof. Ma. Susan Chan, MAN + Rash, itching, elevated temperature, chest/back/headache, chills, sweats, increased heart rata, 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 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. Drago 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 10Handout on Blood Transtusion NCM 118 RLE Prof. Ma, Susan Chan, MAN 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 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 nHandOut on Blood Transfusion NCM Prof 118 RLE ‘Ma, Susan Chan, MAN blood bag label and other lab. Blood exam as required before transfusion (Hab & Het.) 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 41.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 folowing IV access. Biood 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-spectic policy frst. Sets for blood components. Administering blood components requires the use of a blood fier, which may range in pore size from 170 to 260 microns. Its 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 difer by product and brand, 12HanOut on Blood Transfusion NOM 118 RLE Prof. Ma. Susan Chan, MAN Facilties should refer to the product monograph and local policy to determine what fitration is required. + Infusion devices. Infusion devices can be used to transfuse blood components (ie. 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 13.If main IVF is with dextrose 5% initiate an IV line with appropriate IV catheter with plain NSS on another site, anchor catheter property and regulate IV drops. 14.Open compatible blood set aseptically and close roller clamp. Spike blood bag carefully; fil 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 V 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 gts. Initially for 15 minutes and then at the prescribe rate (usually based on the patient's condition) 48. 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 KVO 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 13HandOut on Blood Transfusion NCM 118 RLE Prof. Ma, Susan Chan, MAN 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 + 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 ige + Document everything AZ 20.Swifl the bag hourly to mix the solid with the plasma. NB. one BT set that should be used for 4-2 units of blood 21. Wen 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 Het, 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 (DOHIDENR). 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 14HandOut on Blood Transfusion NOM 118 RLE Prof. Ma, Susan Chan, MAN 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 biood is collected to. Citrate — acts as anticoagulant by chelating calcium Blood Transfusion Recovery ‘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 low-risk procedure, serious blood transfusion risks or complications can include some of the following conditions: + Allergic reactions + Fever + Acute immune hemolytic reaction + Blood-bome 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 ntps:rwuw.unitekeotege edu 15HandOut on Blood Transfusion NCM 118 RLE Prof, Ma Susan Chan, MAN Many of our pro biood transfusion tips involve organization, patience, and a detail- oriented nature. Here are a few pro blood transfusion tips from Or. 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 avoi 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 of 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 4.40 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 transfusionassociated —graft-versus-host disease. This means that immunosuppressed patients may require additional precautions (i.e. the blood may also needs to be irradiated) 16HandOut on Blood Transfusion NOM 118 RLE Prof. Ma. Susan Chan, MAN 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 Leam 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 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 38 Tol Leng trac g teteccow tS fp ole Flow Corl Clam 17HandOut on Blood Transfusion NCM 118 RLE Prof. Ma, Susan Chan, MAN Supercal terrporal vin cciptal ven: Posterar aufcuar wi Pople saphenous DIFFERENT INTRAVENOUS SITES 18HancOut on Blood Transfusion NOM 118 RLE Prof. Ma, Susan Chan, MAN Stenie spike Drip chamber x gages tu ‘Back check — valve Por ‘Sider damp —— es IV bing WV pole Roller camp —— regulates rate of IV intusion Gravity -+ dropsimin Pump —» misinr Por ———»q 19