Blood product delivery and monitoring of patient response.
Objective:
To administer blood products in order to replenish volemia, prevent hemorrhagic shock, increase the oxygen-carrying capacity of the blood, and replenish platelets or clotting factors to replenish hemostasis.
Equipment:
– Trough. – Serum holder.
Material:
– Medical treatment sheet with prescribed hemoderivative. – Prescribed blood derivative. – Infusion equipment for transfusion – Pressurizer. – Sharps container. – Anti-allergic plaster. – Sterile gauze. – Sterile gloves. – Antiseptic solution. – Physiological saline solution. – Nursing records.
Procedure:
– Verify the physician’s orders and that the blood product corresponds to the one prescribed. – Verify the patient’s name and surname, blood group, Rh and number of units to be transfused. – Check that crossmatching tests have been carried out and that there is concordance. Check all these data both in the patient’s history, the blood bank documentation and in the blood product bags themselves. – Inspect the blood for alterations; if there is any anomaly, call the blood bank. – Wash hands. – Follow general rules in the administration of medication. – Teach the patient and family signs and symptoms of adverse transfusion reactions. – Place the patient in a comfortable and appropriate position for transfusion. – Take vital signs before starting the transfusion (BP, HR, RF and body temperature). – Check that the venous line is permeable and of adequate caliber for transfusion. If there is no or inadequate venous line, cannulate a new one.
– The temperature of the product to be transfused should be similar to room temperature. – Insert the system into the blood product bag and bleed. – Connect the distal end of the system to the IV catheter in an aseptic manner and secure with adhesive tape. – Adjust the drip rate and monitor during transfusion. The administration time of one unit should not exceed 4 hours. – Remain with the patient for the first 15 minutes from the start of the transfusion, observing the patient to detect possible transfusion reactions. – Take vital signs again after 15 minutes and at the end of the transfusion. – Immediately stop the transfusion in case of any reaction such as fever, chills, urticaria, dyspnea and notify the physician. – Administer physiological saline solution at the end of the transfusion. – Leave the patient in a comfortable position. – Collect the material and dispose of it in the container according to waste segregation criteria. – Remove gloves. – Wash hands. – Record in the nursing documentation: the procedure, type of hemo- derivative and units, date and start time, volume administered, incidences and the patient’s response.
Observations:
– Never inject drugs into the blood bag, only physiological saline solution may be administered at the same time. If it is necessary to administer any medication, wash the IV with physiological saline solution before and after the administration of the medication. – When transfusing any blood product, the system should be changed with each unit. – All blood products should be transfused through approved filter systems.
If a transfusion reaction occurs:
1. Discontinue transfusion. 2. Notify the physician. 3. Assess the patient. Check vitals, urine output and respiratory effort. 4. Remove infusion set and blood product, save to send to blood bank later. 5. Maintain a permeable line with perfusion of physiological saline. 6. Report reaction to blood bank. 7. Record everything that happened.
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