Blood Transfusion: Steps & Procedure

By:Rajesh Konnur

A blood transfusion is the transfer of whole blood or blood products from donor into another person’s blood stream (recipient). This is a life saving maneuver to replace blood cells or blood products lost through many etiology like bleeding, during surgery when blood loss occurs or to increase the blood count in anemic cases.

Types:

Blood is transfused either as whole blood (with all its components) or more often, as individual parts depending on the situation. The different types of blood transfusions are as follows:

1.Red Blood Cell Transfusions:

Red Blood Cells are the most commonly transfused components of blood. The cells carry oxygen from lungs to other body organs and tissues. They also help the body get rid of carbon di- oxide and other waste products.

2. Platelets and Clotting Factor Transfusion:

Platelets & clotting factors help stop bleeding, including internal bleeding. Due to illnesses, body may be unable to produce platelets or clotting factors. In such a condition, regular transfusions of these blood products are necessary to keep the body healthy. These are indicated in cases of hemophilia and other chromosomal abnormality disorders.

3. Plasma Transfusions:

Plasma is the liquid part of a blood. It’s mainly water, but also contains proteins, clotting factors, hormones, vitamins, cholesterol, sugar, sodium, potassium, calcium etc. Plasma transfusion is indicated in case of liver failure or a severe infection etc.

Interventions before Blood Transfusion:

The following steps will have to be followed before blood transfusion-

  1. Check the blood group of the recipient (A, B, AB, or O & Rh+, Rh-)
  2. Check for compatibility.
  3. Check for allergies & other known reactions.
  4. Check frequently vital signs and monitor.
  5. Take written consent from the patient/ patient party.
  6. Insert IV line and prepare for any emergency.

Interventions during a Blood Transfusion:

The following steps will have to be followed during blood transfusion-

  1. Blood transfusion is carried out in IPD/ OPD depending on the need and situation. These are also done during surgery and in emergency rooms.
  2. Check the precautionary assignment.
  3. Monitor vital signs and record it.
  4. Monitor time and date.

Interventions after Blood Transfusion:

The following steps will have to be followed after blood transfusion-

  1. Check and monitor vital signs.
  2. Remove IV Line.
  3. Monitor for complications.

Complications of Blood Transfusion:

I. Allergic ReactionsSome patients have allergic reactions to the blood given during transfusions. This can happen even when the blood given is the right blood type. These reactions may be mild or severe; like anxiety, back pain/ chest pain, breathing difficulty, fever, chills, flushing & clammy skin, low blood pressure, nausea and vomiting. This procedure has to be stopped if the symptoms are severe.

II. Viruses and Infectious DiseasesSome infectious agents, such as HIV, Hepatitis B and C, variant Creutzfeldt Jacob disease can transmit and cause fatal complications.

III. FeverIt is due to body’s normal response to WBC in the donated blood.

IV. Iron OverloadFrequent blood transfusions can cause iron over load mainly in case of thalassemia.  Excessive amount of iron can damage liver, heart and other parts of the body.

V. Lung Injury: Blood transfusion can damage lungs, making it hard to breathe. This usually occurs within about 6 hours of transfusion. Most patients recover. However 5% to 25% of patients who develop lung injuries die from the infections. These patients usually were very ill before the transfusion.

VI. Acute Immune Hemolytic Reaction: It is very serious, but also very rare. It occurs because of mismatching of blood between donor and recipient. The body attacks the new red blood cells, which produce substances that harm the kidneys.The symptoms include chills, fever, nausea and vomiting, pain in chest or back or dark urine.

VII. Delayed Hemolytic Reaction: This is a much slower version of acute immune hemolytic reaction. The body destroys red blood cells so slowly that the problem can go unnoticed until the RBC levels are low.

VIII. Graft – versus- Host Disease: Graft –versus- host disease (GVHD) is a condition in which white blood cell in the new blood attacks the tissue. It is a fatal complication. Patients who have weakened immune system are the most likely to get GVHD.

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