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7/17/24 OLFU - VAL Learning Objectives: Discuss the importance of blood transfusion,...

7/17/24 OLFU - VAL Learning Objectives: Discuss the importance of blood transfusion, blood typing and crossmatching. Verbalize the steps in initiating, maintaining and terminating blood transfusion. Develop empathy to clients who are receiving blood transfusion. 1 2 BLOOD TRANSFUSION BLOOD TRANSFUSION A blood transfusion is the introduction of whole To restore blood volume after severe hemorrhage blood or blood To restore the oxygen components into venous carrying capacity of the blood circulation. 3 4 1 7/17/24 The surface of an individual’s RBCs contains a number of proteins known as antigens that are unique for each individual. A, B, and Rh antigens are the most important in determining blood group or type 5 6 The Rh blood group system Antigens = was discovered in 1940 by Agglutinogens Karl Landsteiner and A.S. Antibodies = Agglutinins Weiner. These naturally occurring antibodies are responsible for the rapid and severe reaction that occurs when ABO- incompatible blood is administered Blood with Rh factor = Rh positive (Rh+) Blood without Rh factor = Rh negative (Rh-) 7 8 2 7/17/24 After exposure to blood containing Rh factor… Rh- mother carrying a fetus with Rh+ blood, or transfusion of Rh+ blood into a client who is Rh- Rh antibodies develop. Subsequent exposure to Rh+ blood places the client at risk for an antigen– antibody reaction and hemolysis of 9 RBCs. 10 Blood typing is done to determine the ABO blood group and Rh factor status. Crossmatching identifies possible interactions of minor antigens with their corresponding antibodies. RBCs from the donor blood are mixed with serum from the recipient; a reagent (Coombs’ serum) is added, and the mixture is examined for visible agglutination. If no antibodies to the donated RBCs are present in the recipient’s serum, agglutination does not occur and the risk of a transfusion reaction is small. Donor’s RBC + Recipient’s serum + Reagent (Coombs’ serum) = Check for Agglutination 11 12 3 7/17/24 Jehovah’s Witness is a Christian religion that believes that taking blood into the body causes loss of eternal life; thus the church decided that members who accepted blood would be shunned by the congregation and denied the church’s sacraments (called “disfellowshipped”). 13 14 Donors are eliminated if: Deferred for individuals who: ➡ History of Hepatitis B or C, ➡Have Malaria or have been HIV infection (or risk factor exposed to Malaria or Hepatitis for HIV infection) ➡ Anemic ➡ Heart disease ➡High or low BP ➡ Most cancers ➡ Pregnant ➡Had recent surgery ➡ Severe asthma ➡Take certain medications ➡ Bleeding disorders ➡ Tattoos or Piercing (12-month ➡ Seizures deferral period) 15 16 4 7/17/24 colloidal osmotic pressure blood clotting Blood and Blood Products for Transfusion 17 18 Blood and Blood Products for Transfusion Blood and Blood Products for Transfusion Product Use Product Use Replaces platelets in clients with bleeding disorders or For extreme cases of acute hemorrhage. Replaces blood platelet deficiency. Fresh platelets are most effective. 1 Whole blood volume and all blood products: RBCs, plasma, plasma protein, fresh platelets, clotting factors. Platelets unit = increases platelet count by about 5,000 platelets per microliter. To increase the oxygen-carrying capacity of blood in anemias, surgery Provides clotting factors. Packed red blood cells and disorders with slow bleeding. 1 unit of PRBCs has the same (PRBCs) amount of oxygen carrying RBCs as a unit of whole blood. Fresh frozen plasma Does not need to be typed and cross matched One unit raises hematocrit by approx. 2% to 3% (NO RBCs) Used for blood replacement following planned elective Albumin and Plasma Blood volume expander, provides plasma Autologous RBCs surgery. Client donates blood for autologous proteins transfusion 4 to 5 weeks prior to surgery. Protein Fraction 19 20 5 7/17/24 Blood and Blood Products for Transfusion Product Use Used for clients with clotting factor deficiencies. Each provides different Clotting factors and factors involved in the clotting pathway; cryoprecipitate cryoprecipitate also contains fibrinogen. 21 6

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