Blood and Blood Product Administration
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- Fresh Frozen Plasma (FFP): May transfuse for up to one (1) hour. (~ 250 ml)
- Cryoprecipitate: May transfuse for up to one (1) hour. Single and pooled. (~90-120 ml)
- Platelets (PLTS): May transfuse for up to one (1) hour. (~250 ml)
- Red Blood Cells (RBCs): May not transfuse for more than four (4) hours. If using an infusion pump, the rate should NOT exceed 200 cc /hour. Pressure infusions using a rapid infuser or pressure cuff are ONLY done in the critical care areas or Operating Room.
Vitals signs need to be check: Please include a full set of vitals that includes pain and temperature
- Prior to start of infusion
- 15 minutes after start of infusion
- Then, Every hour until infusion stops
- End of the infusion
Signs and Symptoms
- Sense of doom
- Pain at site
- Abdominal, Flank or Chest Pain
- Shortness of Breath
|Type||Mechanism of Action|
|Allergic Reaction||Allergic reactions occur when patients have antibodies that react with proteins in transfused blood components.|
|Acute Hemolytic Reaction||Incompatible transfused red cells reaction with patient's own Anti-A or Anti-B|
|Septic Shock||Transfusion of bacteria contaminated blood component|
|Transfusion-Related Acute Lung Injury (TRALI)||Acute respiratory distress due to donor plasma containing antibodies against the patient's leukocytes.|
|Fluid Overload||Toomuch fluid is transfused or too quickly leading to pulmonary edema and acute respiratory failure (ARF)|
|Non-Hemolytic Febrile Reaction||Patients antibodies reacts to transfused white cells causing a fever|
- Stop the transfusion immediately.
- Hang new tubing and keep the intravenous line open with normal saline.
- Notify the physician immediately of suspected transfusion reaction to obtain transfusion reaction follow up orders (i.e. first urine).
- Notify Blood Bank
- Perform a blood/blood product “records” check with blood bank CLS to re-verify:
- Patient’s name
- Date of birth
- Medical record number
- Blood Bank tag
- Blood type
- Expiration date and time
- Unit number on the blood tag compared to the blood/blood product
- Complete the suspected transfusion reaction Record on the patient’s EHR as well as the paper copy of the “Transfusion Reaction Record” located on the back of the “Crossmatch Transfusion Record”.
- Send Transfusion Reaction Record along with remaining blood/or blood product bag and all the tubing in a biohazard bag to the blood bank.
- Submit a notification of adverse event through the electronic occurrence reporting system to the Risk Management and Quality Department.
- Provide further clinical testing and supportive care as ordered by the physician and/or blood bank medical director.
Pending Permission to post downtime forms