How To Give A Blood Transfusion – OSCE Guide

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اشترك في: الخميس إبريل 04, 2013 10:28 pm

How To Give A Blood Transfusion – OSCE Guide

مشاركةبواسطة دكتور كمال سيد » الأربعاء إبريل 17, 2013 6:12 am

clinical skills definition
clinical competance

is The capability to perform acceptably those duties directly related to patient care


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How To Give A Blood Transfusion – OSCE Guide
https://geekymedics.com/blood-transfusion-osce-guide/

Collecting the initial blood sample

1. Ask patient their name & D.O.B & compare this to their identity bracelet to ensure they match
2. Collect blood sample into the bottles used for blood transfusion in your particular hospital
3. Copy the patient details from the identity bracelet onto the bottle AT THE BEDSIDE!
4. Complete the corresponding blood transfusion form, indicating how many units you require
5. Send or take the bloods to the lab for analysis of blood type & preparation of units
How to prescribe the blood transfusion
1. Each unit of blood needs to be prescribed separately
2. This will need documenting accurately:
• The way in which this is done varies between hospitals
• Usually there is an area on the prescribing chart for IV infusions
• You should document time & date of infusion as well as the reason for transfusing
3. Generally a unit of blood is transfused over a 4 hour period (in a non-urgent scenario)
4. You should arrange to have the blood delivered to the ward (or get it yourself)
5. Blood needs to be given within 30 minutes of leaving the refrigerator – so avoid any delay!
How to check the blood transfusion
1. Request another nurse/doctor to go through the checking procedure with you
2. Ensure patient details on bracelet, notes & blood compatibility report all match EXACTLY!
3. Check blood group & serial number on blood bag matches the compatibility report
4. Check the expiry date & time on the unit of blood to ensure it has not expired
5. Inspect blood bag for:
• Signs of tampering
• Leaks
• Discolouration
• Clots
• Do not administer blood if any of these are seen!

Administering the blood
1. The patient obviously will require a cannula – see our how to cannulate article here
2. Attach the giving set to the blood bag & run some blood through the tubing to expel any air
3. Once sure all air has been expelled, attach other end of giving set to the cannula port
4. Set the drip rate to match the amount of time you want to give the blood over
5. You & a colleague should document the time/date the transfusion was started & sign to confirm all checks were carried out
Monitor the patient!
Monitoring the patient is an incredibly crucial part of the transfusion process
The patients baseline observations should be taken at 0, 15, 30 mins from onset of transfusion
They can then be done on an hourly basis and again when the transfusion has finished

Regular observations allow early detection of transfusion related reactions such as:
• Acute haemolytic transfusion reaction - ABO group mismatch – occurs soon after transfusion¹
• Delayed haemolytic reaction - Usually due to Rhesus Ab²
• Transfusion Related Acute Lung Injury - donor plasma containing antibodies against host³
• Non-haemolytic Febrile Reaction 4
• Anaphylaxis – recipient is allergic to protein components in donor transfusion

References

1. Covin RB, Evans KS, Olshock R, Thompson HW (2001). “Acute hemolytic transfusion reaction caused by anti-Coa”. Immunohematology17 (2): 45–9. PMID 15373591.
2. Noizat-Pirenne F, Bachir D, Chadebech P, et al (December 2007).“Rituximab for prevention of delayed hemolytic transfusion reaction in sickle cell disease”. Haematologica 92 (12): e132–5.doi:10.3324/haematol.12074. PMID 18055978
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