15 easy steps to perform a blood transfusion
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| Step 1 | Type & crossmatch is drawn and run by the lab when a blood transfusion is ordered. This process usually takes 2-3 hours, but may be even longer.(for example:actual time of request to Red Cross, pt.'s own antibodies)
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| Step 2 | Blood bank ID band is placed on patient
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| Step3 | Consent form is signed prior to blood administration. This includes informing the patient of possible side effects of a blood transfusion reaction.
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| Step 4 | 2 nurses id blood bank #, blood type of donor, blood type of pt, donor #, ordered components, & expiration date.
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| Step 5 | Once the identification process is completed, both nurses sign the blood tag.
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| Step 6 | Blood is given via a large gauge IV catheter (18 or 19 gauge) or via central line per protocol.
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| Step 7 | Blood must be hung within 20 mins of getting it from blood bank.
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| Step 8 | Blood is administered w/ a Y set which has 2 ports so NS can be used to prime the line and to make sure all blood has been infused.Takes anywhere from 1-4hrs. Each unit must be completely infused in 4 hrs.
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| Step 9 | LR & dextrose are contraindicated because they result in hemolysis of RBCs. USE NS!!!
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| Step 10 | VS are taken 15 mins after start of infusion, every 30 mins during infusion, & 60 mins after infusion is complete.
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| Step 11 | Each unit of blood must infuse within 4 hours.
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| Step 12 | At any time if there is a sign of a reaction in the pt transfusion is stopped, & the blood tubing & bag is sent to the lab. Physician is notified & IV line is kept patent w/ saline.
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| Step 13 | Notify the patient that this process could be lengthy. At times, it may take a while to T&C due to each individuals own blood. Offer if able, to come to the lab first to have the T&C done first then return to the hospital when the blood is ready.
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| Step 14 | Notify the patient that for a transfusion of 1 unit the process usually will take 7-8 hrs and then add 2-3 hours for each additional units of blood. This of course is an example of an uneventful transfusion.
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| Step 15 | Notify patient that in event of a transfusion reation that the transfusion will cease and further lab testing will be required.
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