Blood Transfusion Techniques in Practice
Blood Transfusion Techniques - Before transfusion, check once again the nature and type of the blood and blood compatibility between donor and patient. Patients prepared with the installation of large-bore IV # 16-18. Needle that is too small (# 23-25) can cause hemolysis. (9.10)
Transfusion is done with the transfusion set that has a filter to block fibrin clots and other debris particles. Transfusion sets have standard sieve and pore size 170 microns. In normal circumstances, a transfusion set can be used for 2 to 4 units of blood. (8.9)
Best vein for cannulation of venous blood is on the hands and on the dorsal part of the upper arm. In an emergency can be done to ensure smooth venesection and transfusion rate. (5.11)
Time taking blood from the fridge, watch plasma. If there are signs of hemolysis (dark brown, turbid) should not be given. Transfused blood will not have to remain in the refrigerator. (6.7)
Blood Transfusion Techniques
Before transfusion, given first 50-100 mL of NaCl physiological. Do not use other solvents because it can be detrimental. Dextrose solution and hypotonic saline solution can cause hemolysis. Ringer's lactate or other calcium-containing solution will cause coagulation. (6.8) Do not add any medication into the blood transfused. The drugs have different pH which can cause hemolysis, transfusion reactions occur anyway if it would be difficult to determine whether it was caused by the drug or due to transfused blood. (8.10)
If a large amount of blood to be transfused within a short time, it is necessary to warm blood, because blood is cold will lead to ventricular arrhythmias and even death. Blood warmed with hot water should be at a temperature of 37-39oC. Because when over 40 ° C, erythrocytes will be damaged. (5) In the first 100 ml of whole blood administration should be scrutinized carefully and slowly given to the possibility of early detection of transfusion reactions. (5,6,8)
Drain blood transfusion sets in 1 ml of 20 drops. Fastest rate that can be achieved is 60 ml per minute. (11) The rate of transfusion depends on the cardiopulmonary status of the recipient. If normal cardiopulmonary status, it can be given 10-15 ml/kgBB within 2-4 hours. If there is no safe limit hemovolemia the transfusion was 1 ml / kg / hour (1 unit approximately 3 hours) or 1000 ml in 24 hours. (4.12) But if there is heart failure that threatens the transfused should not exceed 2 ml/kgBB/hour. (3) since the blood is an ideal culture medium for bacteria, preferably one unit of blood transfusion cannot exceed 5 hours due to the increased risk of bacterial proliferation. (6,8,12)
Cases with massive bleeding sometimes it takes transfusion rapid up to 6-7 bag in half an hour. Having looked improved circulation is reduced to 1 bag per 15 minutes. (5.6)
Not recommended giving antihistamines, antipiretika, or diuretics are routinely before transfusion to prevent a reaction. Reaction heat is basically a sign that there was a danger of transfusion reactions. Diuretics only required in patients with chronic anemia who need transfusions to 20 ml/kgBB in 24 hours. (12)
Ways of Improving Blood Transfusion Speed: (9.11)
- Put a bottle of blood as high as possible. Causes an increase of 2 times the speed of transfusion increased 2 times anyway.
- Use a needle or cannula as possible.
- Increases blood pressure by pumping air into the bottle.
- With blood-pumping blood inside the catheter below.
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