Question

To safely administer blood product to clients, Nurses should be vigilant through all the steps of transfusion: storage, transportation, handling, checking and disposing of blood bag and related waste. In the table given below, you will find each of these steps or variables and some choices given for each of the variable. Read the choices and complete the table as required. (30-50 words each) CRITICAL STEPS What is the correct technique/ way /procedure? 18.1) Storage 18.2) Transportation 18.3) Handling 18.4) Checking 18.5) Administration 18.6) Disposal

Answer 1

Blood transfusion refers to transfusing blood to a recipient from a donor as a life saving treatment.

The techniques used in this are

• Direct transfusion : from the donor to the recipient intravenously
• Indirect transfusion :The blood is collected in a container consisting of anticoagulant to sore as its nature
• Whole blood transfusion with syringe: Here the blood is collected in the syringe and transfused before clotting.Still practiced in neonatal blood transfusion
• Whole blood transfusion with Kimpton's tube:The clotting is prevented by the application of the paraffin wax in the chamber where the blood is collected

The procedure of blood transfusion are

• Donation of the blood
• The blood is processed and tested for infectious disease like HIV,HCV,HbsAg,Malaria
• Compatible testing is done

18.1)Storage

• Whole blood should be stored between 2°C to 6°C. Storing below 2 degree Celsius will freeze and cause heamolysis
• RBC can be stored for 42 days and frozen for 10 years
• Fresh frozen plasma should be stored between _70°C to _30°C.
• Liquid plasma should be stored below _30°C
• Platelet should be stored at 22°C in plasma ,pH should be above 6.8  and temperature at 200°C.It can be stored only for 5 days

18.2) Transportation

The blood should be transported in a transit container,packing materials, proper label, documentation,melting ice without direct contact with the blood ,avoiding direct heat or extreme temperature, minimizing dead space,written consent for transportation are necessary got safe practice.

18.3)Handling

The blood has to be handled in a aseptic manner to avoid any infections.It has to be handled by the staff who is going to transfuse it.

18.4)Checking

The checking starts right from the blood bank where the blood products are received.In most of the places the resident physician has to check for order and the blood pack and sign on the consent paper.This is followed by the counter checking by a nursing supervisor side and finally the RN who transfuses it checks and signs the consent paper.

18.5)Administration

Before administration it has to be explained to the patient and the relative for the indication for transfusion. Prepare the tray for with required things for transfusion, The patient has to assessed for vitals,pre medication (Ink.Avil,Inj.Effcorlin) as per order, IV line insertion if not present ,Connect blood set to the patient and start and transfuse slowly for first 15 minutes (5_6 drops per minute ) to assess for any reactions. After 15 minutes transfuse at the standard rate of 20 drops per minutes over 4 hours or as per order.

18.6)Disposal

The blood bags after transfusion has to be removed and put in a yellow bag along with the blood set and the empty bag has to be sent back to tge blood bank where it is usually disposed as bio medical waste as a whole.