• to restore circulating blood volume
• to increase # of RBC and Hgb
• to provide selective cellular components such as platelets

Blood has 2 parts:

• cellular à RBC (which carry ABO antigens), WBC, & platelets
• plasma

A à 41% of the population

B à 10%

AB à 4% : universal recipient

O à 45% : universal donor and can only receive O

Most transfusions are done with same blood type. O neg is given in emergencies.

Autologous: donates blood to themselves, such as when they know they are having surgery.

Homologous: donated by others.

Requirements for donating: 110 pounds, 99.6 temperature, range of V/S within normal paremeters, Hgb above 0.7, and age between 17-65.

Complication of blood donation: fainting, especially if you have had nothing to eat.

• most commonly given
• contain Hgb (12-16 is normal)
• 8 or 9 Hgb will get a transfusion
• transfusion will increase Hgb by 1g
• increases O2 carrying capacity
• infusion time is 1 ½ -2 hours, Max is 4 hours
• RBC’s will break down after 2 hours
• Volume = 300-350cc
• Runs at 125-150cc/h
• Use a filter
• Needs to be hung within 30 minutes out of fridge

• fluid portion of the blood
• hung with filter
• if bleeding or used for clotting factor, given over 15-20 minutes
• if not bleeding, given over 1-2 hours

• normal count is 150,000-300,000
• less than 50,000, then transfused
• each unit increases count by 10,000
• no RBC, so don’t have to match
• MD may order 8 units (or whatever amt) but all of it will be in 1 bag
• Infusion time: as fast as the client can tolerate, usually 150cc/hr

• clotting factor 8
• extracted from plasma
• infusion time: 30 minutes to 1 hour
• we don’t give this very much

• 1 unit = 500cc
• each unit will increase Hgb by 1g

Procedure to give: page 1284

RN hangs blood.

LPN may NOT hang blood.

RN gets and is checked with MLT before blood leaves lab.

Checked again at the unit.

LPN can check blood with an RN according to agency.

What is checked:

• patient name with lab slip, card on blood, armband
• expiration date on blood with expiration date on lab slip
• medical record # on lab slip, blood slip and arm band
• donor # with lab slip and blood slip
• donor type and patient type

Check MD order

Fill out lab slip and send it in.

Find out if client has ever had a transfusion and if had problems with it.

Explain procedure.

Obtain consent.

Have IV line wih 18 gauge needle (this is the best choice).

RBC will break with a gauge that is smaller.

Prime tubing with NS always.

Do not give meds with blood.

Dextrose will break it down.

Obtain baseline v/s. If fever is 101 call MD before tranfusing.

Check IV site.

Ask about back pain before it starts.

Check urine color.

Lung sounds.

Go pick up blood.

Agitate bag to keep moving.

Wash hands.

Put on clean gloves.

Spike bag.

Close saline clamp.

Open blood clamp.

Filter should not be used more than 4 hrs.

Open flow rate.

1^st 15 minutes run at 20gtt/min.

Then increase so it will run in 2 hours.

V/S checked at 15, 30,1 hour then every hour.

Document: blood #, type, v/s, assessment

LPN can monitor infusion.

May pre-medicate with benedryl before or lasix between each bag.

After infusion, switch back to saline until filter is flushed.

Check v/s.

Document time completed, amount infused, v/s and reaction.

Lab has v/s section for before and after and what reaction.

Dispose of according to agency policy.

Can be hung using a pressure cuff, so it can be given quickly.

May need to warm the blood first with a blood warmer depending on client’s needs.

Complications: in fundamentals book (p 1286).