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Blood Transfusion And Blood Components
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| Blood Transfusion And Blood Components |
Blood transfusion is a surgical intervention by which means blood is given to the patient. As a rule, before a patient is transfused with blood, his blood group must be known and a direct cross-matching test performed. However, in a dire emergency, an uncrossed matched group o rhesus negative blood can be given. This carries a great risk.
BLOOD COMPONENTS
1. Whole blood
2. Packed cell
3. Plasma
4. White blood cell
5. Platelets
6. Cryoprecipitate
Factor VIII concentrate Factor IX concentrate Fibrinogen Albumin Immunoglobulin
INDICATIONS FOR BLOOD TRANSFUSION
1. To restore circulating blood volume as in cases of acute blood loss and severe burns.
2. To restore the hemoglobin content of the blood as in severe anemia.
3. Bleeding disorders as in thrombocytopaenia ant mogul defect
4. To reduce infection
5 Immunoglobulin therapy is in cases where an Rh woman gave birth to an Rh child and in immure deficiency states such as measles.
COLLECTION AND STORAGE OF BLOOD
the interval between donations should not be less than six months.m who gave birth a year ago can be allowed to donate blood.
1. No donor should donate more than twice within one year
2. Pregnant women are not to donate blood. However, a woman
3. Those that have been vaccinated recently and specifically less
4. Unsuitable donors are those with viral infections especially the
human immune deficiency virus, HIV; protozoal, spirochaetal, and then two months ago are not suitable to donate blood. bacterial infections.
5. Those with Glucose – 6 – phosphate dehydrogenase deficiency is also unsuitable. It is preferable to collect blood in plastic bags than in bottles.
The bags are used to contain either Acid Citrate Dextrose (ACD) or Citrate Phosphate Dextrose (CPD). The storage temperature of the blood is about two or four degrees centigrade. It is advised that blood should not stay for too long in the bank to avoid depletion of clotting factors and immune bodies. ACD stored blood has a life span of twenty-one days.
There is depletion of 2,3 di-phospho-glycerate within fourteen days of storage. The citrate in the blood is metabolized and this results in hyperkalemia. The red blood cell becomes less viable. In CPD stored blood, 2,3 diphosphate glycerate is preserved and not as depleted. The life span of CDP stored blood is twenty-eight days. The red blood cell is more viable than in ACD stored blood. Its disadvantage is that it causes platelet aggregation.
BLOOD TRANSFUSION REACTIONS
1. Febrile reaction:- A common condition during blood transfusion said to be due to unclean method of handling either during the collection of blood or during the process of preparing it forgiven to stop it. transfusion. Rigor has been reported in some cases. Analgesic is
2. Allergic reaction:- Although the donor’s and recipient’s blood are Compartible, cases of allergic reactions have been reported during a blood transfusion. This presents as rashes on the skin or urticarial wheal. Cases of angioneurotic edema have also been reported. Hydrocortisone is also useful. Treatment is by giving antihistamines such as iron or Phenergan.
3. Transmission of disease:– Viral hepatitis:; malaria, syphilis, and more recently human immunodeficiency virus has variously been reported to have been transmitted through blood transfusion. It is common for malaria to be transmitted in the tropics and this does not pose any serious prob’em in the semi-immune. For the other diseases which are considered deadly, it is important that every blood collecting center should screen the donors before bleeding them.
4. Incompatible blood transfusion:- Granted that the laboratory scientist performed the cross-matching of blood, then this may occur due to accidental mixing up of blood specimens. It is more serious in ABO than in rhesus. The affected patient presents with restlessness, breathlessness, rigors, pain, and urticaria. Late signs are oliguria, jaundice, and hemoglobinuria.
Signs of incompatibility in an unconscious patient include hypotension, cyanosis, and oozing of blood from the operation site if the patient underwent surgery.
The management is to:
- Stop the transfusion.
- Send the remaining blood and a fresh specimen of the patient’s
- blood to the laboratory for re-cross matching.
- IV Hydrocortisone 100mg stat.
- IM Phenergan 25mg stat.
- A diuretic such as frusemide 40mg iv to flush out the kidney,
Diuretic also helps to prevent transfusion overlead.
5. Circulation overload:- This occurs if the transfusion is very rapid or if the volume of blood given is larger than the patient can accommodate. It is more common in patients with inherent heart disease, aged patients, and little children. They present with the tightness of the chest, dry cough, breathlessness, headache, and engorgement of the neck veins. As a rule, the good nurse must at regular intervals check the patient receiving blood for the above-listed transfusion reactions.
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