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Blood Transfusion

Definition

Blood transfusion is a procedure in which the blood or blood components from one person, called a donor, is given to another, called a recipient.

Who is a candidate for the procedure?

People receive blood transfusions for many reasons. Blood transfusions can:
  • increase the blood's ability to carry oxygen
  • restore the body's blood volume
  • improve immunity
  • correct clotting problems
A person may need a blood transfusion if he or she has:
  • lost blood and fluid volume as a result of an injury, surgery, or burns
  • severe anemia, a low red blood cell count
  • a bleeding disorder, such as hemophilia A or hemophilia B
  • an immunodeficiency disorder, a condition that weakens the body's ability to fight off infection

How is the procedure performed?

Most transfusions are given in a hospital. Sometimes they are given in outpatient settings such as an ambulatory care clinic, a doctor's office, or even at home. Unless an emergency exists, a sample of blood will be drawn for blood typing and cross-matching with the blood to be received. The blood type must be accurately identified when a person is to receive whole blood or red blood cells.
The four blood types are known as A, B, AB, and O. Blood will also be referred to as Rh positive or Rh negative, depending upon whether the Rh antigen is present on the membrane of the red blood cells.
As a rule, a person receives donated blood only of his or her specific ABO and Rh type. Some specific exceptions to this principle are possible in emergencies. A careful history and physical will be performed before the transfusion. An intravenous (IV) will be started, usually in the hand or arm.
To reduce the chance of a reaction, healthcare professionals take several precautions. The blood is double checked by two staff to confirm that the blood about to be given is intended for the person about to receive it. Usually, unless the person is in imminent danger of bleeding to death, the blood is run slowly, about one to four hours per pint of blood.
The person's vital signs, such as temperature, pulse, breathing rate, and blood pressure, are closely watched during the procedure. Because an adverse reaction is most likely to occur in the first 15 minutes, the person is watched most closely at first.
Signs and symptoms of a transfusion reaction include:
  • chills
  • fever
  • breathing problems
  • chest or back pain
  • nausea
  • pain at the infusion site
  • hives and itching
  • anything "unusual" or of concern

Sources

Textbook of Medical-Surgical Nursing, Ninth Edition, 2000, Smeltzer, et al

The Merck Manual of Medical Information, 1997

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