Blood Products
PRBCs: increase Hgb/Hct (1 unit raises Hgb ~1 g/dL). Platelets: thrombocytopenia. FFP: clotting factor deficiency, warfarin reversal. Cryoprecipitate: fibrinogen deficiency. Albumin: volume expansion. Irradiated for immunocompromised.
Administration
Verify identity, type, compatibility (two RNs). Y-tubing with NS. Start within 30 min. Infuse PRBC over 1-2h (max 4h). Vital signs: baseline, 5 min, 15 min, hourly, post. Stop immediately if reaction suspected.
Transfusion Reactions
Acute hemolytic (ABO incompatibility): fever, chills, flank pain, hypotension, DIC — STOP immediately. Febrile non-hemolytic: antipyretics. Allergic: antihistamines. Anaphylactic: epinephrine. TRALI: non-cardiogenic pulmonary edema within 6h. TACO: volume overload.
Important Notes
- STOP transfusion immediately if any reaction suspected — do not wait to confirm.
- Acute hemolytic reaction usually caused by clerical error — double-check patient and unit identification.
Clinical Tips
- A single unit of PRBCs raises Hgb by approximately 1 g/dL.
- Platelets should be infused rapidly (15-30 min) — short shelf life (5 days).
Summary
Blood transfusion requires two-nurse verification, strict administration protocol, vital sign monitoring, and immediate response to reactions.
