Blood Transfusion: Procedure, Indications, Risks & Nursing Care, Blood Transfusion Nursing Notes


BLOOD TRANSFUSION

Blood transfusion is a medical procedure in which donated blood or blood components are transferred into a patient's bloodstream. This process is done to replace lost blood, treat medical conditions, or correct blood deficiencies.

1. INDICATIONS FOR BLOOD TRANSFUSION

Blood transfusions are required in various medical conditions, including:

A. Hemorrhage (Severe Blood Loss)

  • Trauma (accidents, gunshot wounds, stab injuries)
  • Surgery (major operations, C-sections)
  • Gastrointestinal bleeding (ulcers, varices)

B. Anemia (Low Red Blood Cell Count or Hemoglobin)

  • Iron-deficiency anemia
  • Chronic kidney disease
  • Cancer or chemotherapy-induced anemia
  • Postpartum hemorrhage

C. Blood Disorders

  • Thalassemia
  • Sickle cell anemia
  • Hemophilia (clotting disorders)

D. Shock & Hypovolemia

  • Severe dehydration
  • Burns
  • Septic shock

2. TYPES OF BLOOD TRANSFUSION

Blood transfusions can be categorized based on the component transfused:

A. Whole Blood Transfusion

  • Contains all components of blood (RBCs, WBCs, platelets, plasma)
  • Used in massive blood loss and trauma cases

B. Blood Component Transfusion

  1. Red Blood Cells (RBCs) – Used for anemia, blood loss, and low oxygen levels
  2. Platelets – Used in bleeding disorders, leukemia, and chemotherapy patients
  3. Plasma (Fresh Frozen Plasma – FFP) – Used for clotting disorders, liver diseases, and burns
  4. Cryoprecipitate – Used in hemophilia, von Willebrand disease

C. Autologous Blood Transfusion

  • The patient donates their own blood before surgery and receives it back if needed

3. BLOOD GROUP COMPATIBILITY

A. ABO Blood Group System

Blood Type Can Donate To Can Receive From
A+ A+, AB+ A+, A-, O+, O-
A- A+, A-, AB+, AB- A-, O-
B+ B+, AB+ B+, B-, O+, O-
B- B+, B-, AB+, AB- B-, O-
AB+ AB+ All Blood Types (Universal Recipient)
AB- AB+, AB- AB-, A-, B-, O-
O+ O+, A+, B+, AB+ O+, O-
O- All Blood Types (Universal Donor) O-

B. Rh Factor

  • Rh-positive (Rh+): Can receive Rh+ or Rh- blood
  • Rh-negative (Rh-): Can only receive Rh- blood

4. PROCEDURE FOR BLOOD TRANSFUSION

A. Pre-Transfusion Preparation

  1. Doctor’s Order – Verify the need for transfusion

  2. Patient Consent – Explain risks and benefits

  3. Blood Sample Collection – Cross-matching and blood grouping

  4. Check for Allergies – Previous reactions to transfusions

  5. Prepare IV Access – Use an appropriate cannula (18G-20G for rapid transfusion)

B. Steps in Blood Transfusion

  1. Check the Blood Bag:

    • Right patient

    • Blood type compatibility

    • Expiry date

    • No clots, bubbles, or discoloration

  2. Monitor Vital Signs:

    • Before transfusion

    • Every 15 minutes for the first hour

    • Every 30 minutes until completion

  3. Start Transfusion Slowly – Observe for reactions within the first 15 minutes

  4. Increase Flow Rate If No Reaction Occurs

  5. Complete Within 4 Hours – To prevent bacterial growth

  6. Dispose of Blood Bag Properly

5. BLOOD TRANSFUSION REACTIONS

A. Immediate Reactions (Within Minutes to Hours)

  1. Febrile Reaction – Fever, chills, headache

    • Stop transfusion, give antipyretics

  2. Allergic Reaction – Rash, itching, anaphylaxis

    • Stop transfusion, give antihistamines, steroids

  3. Hemolytic Reaction (Mismatched blood) – Chest pain, low BP, kidney failure

    • Stop transfusion, call doctor immediately

  4. Bacterial Contamination – Fever, chills, low BP

    • Stop transfusion, start IV antibiotics

  5. Circulatory Overload – Dyspnea, hypertension, pulmonary edema

    • Slow transfusion rate, give diuretics

B. Delayed Reactions (Days to Weeks)

  1. Iron Overload – Seen in multiple transfusions (treat with iron chelators)

  2. Graft-Versus-Host Disease (GVHD) – Rare but fatal in immunocompromised patients

6. POST-TRANSFUSION CARE

  • Monitor vital signs and urine output

  • Observe for late reactions

  • Encourage hydration

  • Document procedure and patient response

7. NURSING RESPONSIBILITIES

  • Ensure correct blood type matching

  • Monitor for transfusion reactions

  • Educate the patient about signs of reactions

  • Maintain strict infection control

CONCLUSION

Blood transfusion is a lifesaving procedure but requires careful monitoring to prevent complications. Proper nursing care and adherence to safety protocols ensure a successful and safe transfusion.


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