blood transfusion reaction

Blood Transfusion

Q16. Before giving blood transfusion a nurse nust note the date, time of collection and must be award that Packed RBC's can be stored up to ?

A. 25 days

B. 35 days

C. 45 days

D. 55 days

Right answer- B

Blood store in blood bank ( anticoagulant )

1. 21 days with ACD → ( ACD- Acid Citrate dextrose )

2. 28 days with CPD →   ( CDP-Citrate Phosphate dextrose )

3. 35 days with CDPS →  ( C - Citrate D - Dextrose P - Phosphate A - Adenine )

4. EDTA - Ethylene diamine tetra acetic acid

ACD → (Acid citrate dextrose) cantaing blood

⦁ Citrate + Ca+   →  Urine excretion increased

                                         ↓

                                 Hypocalcemia

EDTA- it is not used in blood transfusion as it has no advantage over Citrate it is toxic and damaging platelet it is used preserving blood samples only

Blood bank mostly used anticoagulant -CDPA

 Prolonged storage blood  → RBC Hemolysis 

 ↓

Hyperkalemia

                                                      ↓

                      K- cause-cardiac dysrhythmia, acidosis 

platelets store room temperature per 4- 5 Day store 

Store blood living malaria Parasite 21 days 

35 days after Store Blood Component changes 

• PH - Less

• HB - less

• Hematocrit - less

• Platelets - less

• K + - More (hyperkalemia)

Blood Transfusion-

• Never to be infused with a large amount of refrigerated blood.

• Because it cause cardiac dysrhythmia

• No solution other than NS should be added

• Never to be added medication during the blood transfusion

• Decreased the risk of septicemia.1 unit blood should not be exceeds greater than 4-6 hrs (Max time=6 hrs )

• BT-set should be changed after 1 unit.

• Blood को refrigerator से बहार निकालने पर 20-30 min wait करते है

• Blood should be infused within 20-30 min in case of delay sent back to the laboratory.

• Before & after BT vital sign checked (To identify infection).

• Given Close monitoring first 15 min and first 50 ml blood volume administration .

• BT Conformation is presence 

• In case of any type of transfusion reaction premedication treat with diphenhydramine

Blood Transfusion Complication- 

1. Iron overloaded (hemosiderosis) Excessive iron deposition

•  Delayed type complication

•  Cause-Caused by massive b/d transfusion and totally dependent on b/d transfusion.

⦁ S/S-

•  Vomiting

•  Diarrhea

•  Hypotension

Treatment- DOC-(Deferoxamine)

•  Urine color turns into –red ,organ,brown.

Intervention- Document finding.

2. Hypocalcemia-

⦁ C/S-

•  Chvostek's Sign- facial muscle पर tapping करने पर muscle/ particular part (face) एक तरफ खींच जाना

• Trousseau's sign- B.p. cuff बांधने के बाद cuff inflation के time बाद sudden related extremity की finger का tetanic condition में हो जाना

•  Tetanic condition- muscle spasm.

• ⦁ECG- ST & QT interval का prolonged हो जाना

3. Disease transmission- 

•  HIV

• Hepatitis B

• Hepatitis C

•  Septicemia-

4.Microorganism-puncture site-located

Systemic septicemia (increase temp.) then notify the physician

S/S-

•  increased temp.

•  Chills, rigor, redness

•  Drainage at the site

•  Hypotension

•  Collapsed-death

5.Hyperkalemia-

•  Prolonged storage b/d K cause-cardiac dysrhythmia, acidosis 

•  21 days-35 days K= 3.5 to 5.meq/L 

•  K+RBC Hemolysis

E.C.G.-

•  Flat P-wave

•  Widened QRS-complex

•  Peaked T-wave

•  Prolonged PR- interval

D.O.C.-

•  Kaxylabe

•  NaHco3 –To treat Acidosis

•  Ca-gluconate-to treat cardiac irritability BT rate=40 drop/min

•  Insulin In 21 storage K=23 mg/l

• In 1 day storage K=7 mg/l

6. Transfusion Reaction-

•  Close observation- 

• 15 min(first) Transfusion Reaction के ज्यादा chances and First 50 ml blood 

S/S- 

•  Chest pain 

•  Dyspnea

• Back pain

•  Itching

•  Fever

Prevention- (transfusion reaction)

Premedicated treat with Diphenhydramine & acetaminophen

• Orally- before B/t -20-30 min administer

• IV- before B/t -5min

Intervention-

• Stop the transfusion immediately

• N.S. to admit emergency drug +drugs

• Notify the physician

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Nursing Officer

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