Blood Transfusion

Circulation · General · 10–20 min

Safe administration of blood or blood components with proper checks and monitoring.

Indications

  • Hb < 7 g/dL (7–8 in cardiac disease)
  • Active bleeding
  • Symptomatic anemia

Contraindications

  • Patient refusal (JW — respect wishes)
  • Volume overload without urgent need

Equipment

  • Cross-matched unit
  • 18-G IV access
  • Blood-giving set with filter
  • Baseline vitals
  • Emergency drugs available

Positioning

  • As appropriate for the procedure and patient comfort.

Consent

  • Explain indication, benefits, alternatives
  • Explain risks & complications
  • Obtain written/verbal consent as per SOP
  • Document consent

Universal precautions

  • Hand hygiene
  • PPE — gloves, mask, eye protection
  • Aseptic technique
  • Sharps safety
  • Verify patient identity & site

Step-by-step (0/7)

Tap to complete

1. Check indication & consent

Documented.

2. Bedside checklist

3. Baseline vitals

4. Start slowly

5. Full rate

6. Vitals monitoring

7. Complete cycle

Immediate complications

  • Acute hemolytic reaction (ABO)
  • Allergic/anaphylaxis
  • TRALI
  • TACO
  • Febrile non-hemolytic
  • Bacterial contamination

Delayed complications

  • Delayed hemolysis
  • TA-GVHD
  • Iron overload
  • Infection transmission

Recognition

  • Fever, chills, back pain, hypotension, dyspnea

Initial management

  • STOP transfusion
  • Keep line with saline
  • Send unit + samples to blood bank
  • Supportive; steroids/antihistamines/pressors as needed

Prevention

  • Bedside checklist
  • Correct sample labelling
  • Group-specific

Post-procedure observation

  • Vitals q15min × 1h then hourly

Monitoring

  • Site inspection
  • Symptom review

Documentation

  • Procedure note
  • Consent
  • Findings

Patient instructions

  • Report pain, bleeding, fever, worsening symptoms

Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.

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Clinical Decisions in Seconds