Pages

Thursday, November 19, 2015

THE RIGHT WAY OF ADMINISTERING BLOOD PRODUCTS ๐Ÿ’ง๐Ÿ’ง๐Ÿ’ง๐Ÿ’ง๐Ÿ’ง [ from "THE CLINICAL USE OF BLOOD: HAND BOOK , World Health Organization & Blood Transfusion Safety , GENEVA ]


✔️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. 


No comments: