✔️Prefer a larger cannula: A doubling of the diameter of the cannula increases the flow rate of most fluids by a factor of 16.
✔️In case of Whole blood, red cells, plasma and cryoprecipitate
>Use a new, sterile blood administration set containing an integral 170–200 micron filter
>Change the set at least 12-hourly during blood component infusion
>In a very warm climate, change the set more frequently and usually after every four units of blood, if given within a 12-hour period
✔In case of Platelet concentrates
>Use a fresh blood administration set or platelet transfusion set, primed with saline.
✔️WARMING BLOOD:
>There is no evidence that warming blood is beneficial to the patient when infusion is slow.
>At infusion rates greater than 100 ml/minute, cold blood may be a contributing factor in cardiac arrest. However, keeping the patient warm is probably more important than warming the infused blood.
>Warmed blood is most commonly required in:
[1]Large volume rapid transfusions:
-Adults: greater than 50 ml/kg/hour
-Children: greater than 15 ml/kg/hour
[2]Exchange transfusion in infants
[3]Patients with clinically significant cold agglutinins.
>Blood SHOULD ONLY BE WARMED in a blood warmer. Blood warmers should have a visible thermometer and an audible warning alarm and should be properly maintained.
>Blood should never be warmed in a bowl of hot water as this could lead to haemolysis of the red cells which could be life-threatening.
✔️Severe reactions most commonly present during the first 15 minutes of a transfusion. All patients and, in particular, unconscious patients should be monitored during this period and for the first 15 minutes of each subsequent unit.
✔️The transfusion of each unit of the blood or blood component should be completed within four hours of the pack being punctured. If a unit is not completed within four hours, discontinue its use and dispose of the remainder through the clinical waste system.
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