BLOOD TRANSFUSION/ ADMINISTRATION (FOLLOW THE DOCTOR ORDERS AND YOUR FACILITY POLICY AND PROCEDURE)

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The doctor has ordered blood transfusion for your patient.

Enter for type and screen or type and crossmatch.

The order must be within 72hours. After 72 hours you will need a new doctor order for blood transfusion.

If patient Hemoglobin level is low and there is no order for blood transfusion. Call the doctor to get an order,put in the order for the Blood Bank and the lab will send the phlebotomy to collect specinen for type and screen or type and crossmatch.

The doctor will talk to the patient. CONSENT for blood transfusion must be signed. Patient must consent to receiving blood otherwise DO NOT transfuse.

Based on your hospital policy blood will be picked up from blood bank by nursing staff,technician or will be delivered via secured code through the tube system.

THE BLOOD TRANSFUSION/ADMINISTRATION.

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Have your pump ready because pump may be used.( Follow your Hospital protocol on blood administration) Use 16guage or 18guage, or 20guage IV.

I will not recommend 22guage.

But sometimes 22guage can be used but you have to keep your eyes on it because it is a small guage,a bigger guage is needed due to the viscosity of blood.

IV site must be patent/clean/dry .

And must be dedicated to blood transfusion only.( No medication administration or IV solutions to the blood transfusion site)

Check the blood by licensed professionals of which one of them must be an RN.

Do patient have fever?.Notify the doctor Tylenol 650mg mg po and benadryl 25mg may be ordered by the doctor before blood transfusion .

Give medication 30minutes before blood transfusion.

Do not transfuse when patient is running high temperature of > 100.4°F.

Please follow doctor orders and your hospital policy and procedures.

Change blood transfusion tubing after every 2units of blood is given.

Do not use the tube after giving blood transfusion or fresh frozen plasma for PLATELET.

Change tube after giving packed red blood cells or fresh frozen plasma before giving Platelet. Use a pall filter if infusing rate of 4ml/kg/hr to prevent microembolization or blood transfusion filter per your facility policy and procedures.

Vital signs 15minutes before blood transfusion.

15 minutes after you start blood transfusion stay with patient and monitor and take vital signs.After completion of blood transfusion check vital signs. Discard the tubings.Proper documentation in the computer from the beginning to the end of blood transfusion.

Monitor patient 1 hour post transfusion.

H/H 1 to 2hours after blood transfusion. Put in the order for laboratory draw by phlebotomy post transfusion.

Recently the doctors often order to transfuse only 1 uinit of PRBC.

Monitor patient with Cardiac issues, respiratory tissues, Cardiac failure.

These patients might need diuretic such as lasix due to fluid overload and blood should be given slowly. Close monitoring of these patients is very important. Only 1 uint of blood in 12 hours. Always follow doctor orders if you are not sure consult with your colleagues.