Patient
Preparation
Prior to Transfusion
Prior
to Mis-O-GRAMing for blood release, take and record the patient's
blood pressure, pulse and temperature. If a patient is febrile,
consider postponing blood transfusion. The fever may complicate
the recognition of a febrile reaction to the blood itself.
MIS-O-GRAM the
request for blood release only after adequate venous access is established.
Verify the patient's
identification information on the blood unit with the information
on the recipient's wristband. This clerical check must be performed
by two qualified health professionals trained in blood administration
procedures. If the patient is alert, ask him/her to state his/her
name.
Two qualified
health professionals must verify that the Typenex bracelet matches
the information on the patient wristband and the blood unit. Make
sure the Typenex number on the bracelet matches that on the blood
unit. Proper patient and unit identification is one of the most
important steps in the transfusion process. If any discrepancy
is noted, notify the DTM at once and return the blood product until
the discrepancy is resolved.
Document the
names of the two individuals performing the clerical check in the
MIS chart. Also record the name of the person beginning the transfusion.
This person must be certified in blood administration.
Immediately
prior to transfusion, mix the blood component by gentle inversion.
Normal saline
and PlasmalyteTM are the only IV solutions considered compatible
with blood components.
During Transfusion
Observe
the patient closely during the first 30 minutes of the transfusion.
Infuse the product
slowly (e.g., 2 mL/min)
Repeat vital
signs 15 minutes after the transfusion is initiated and at the completion
of the transfusion.
Monitor the
patient for signs of fever, chills, lumbar pain, dyspnea,urticaria,
pruritus, joint pain, nausea, vomiting, hemoglobinuria, anuria or
bleeding.
If any of the
symptoms occur, follow the instructions under Adverse Reactions.
In all cases
of suspected reaction, temporarily terminate the infusion and keep
the IV line open with normal saline until the nature of the reaction
is determined.
Promptly notify
DTM staff in all cases of suspected transfusion reactions
(301 496-8335 or 301 496-3608).
If a unit of
blood or a blood component cannot be immediately transfused it must
be returned to the Blood Issue area within 30 minutes of issue to
avoid wasting the product. If the blood or blood component has been
entered on the nursing unit and is unable to be completely infused,
return it to the DTM for disposal.
Following the
completion of the transfusion, chart the required information into
MIS (see MIS instructions).
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