Blood Transfusion Chart Decrease Blood Component Adult Pediatric Estimated Volume Duration Effect Non bleeding 70 kg adult Dose rate Max dose and or max rate All first 15 minutes 100 mL hr 2 mL kg hr Do not exceed 100 mL hr Red Blood Cells 350mL 1 4 hrs One unit will increase hematocrit by approximately 3 or hemoglobin by 1gm dL 2 5 ml kg hr
STEP ONE STOP THE TRANSFUSION Don t disconnect the unit though that will eventually happen at least stop the incoming flow of blood Leave the line open with saline Compare to pretransfusion sample if abnormal Poor phlebotomy technique traumatic stick drawing through IV line d Repeat ABO Rh testing 5 Acute Transfusion Reaction Chart Consider Recommended Investigations and Suggested Treatment and Actions in the context of each patient s specific clinical scenario and blood component product transfused
Blood Transfusion Chart Decrease
Blood Transfusion Chart Decrease
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Blood Transfusion Monitoring Chart
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Drop in systolic BP more than or equal to 30 mmHg and systolic BP less than or equal to 80 mmHg Bradykinin is believed to have a major role in producing hypotension Patients taking ACE angiotensin converting enzyme inhibitor medication decreased bradykinin degradation related to increased angiotensin converting enzyme Labelling errors result in sample rejection This causes delays Positive Patient Identification It is essential that patients must be asked to state their name and DOB Essentials for labelling blood samples Use 4 identifiers First name surname date of birth and unique identification number In Wales need address as well
Within 10m of starting cryo dyspnoea sats 64 RR30 HR125 increased BP Despite diuresis continued worsening CXR patchy consolidation in both lungs 70 yr old woman with a pneumonia and pulmonary hypertension became hypoxic 5 hours after a unit of platelets Currently guidelines for the transfusion of red blood cells RBC generally follow a restrictive threshold While there is some variation in the number for the threshold 7 g dL is an agreed upon value for asymptomatic healthy patients
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Practice guidelines from the AABB Red blood cell transfusion thresholds and storage JAMA doi 10 1001 jama 2016 9185 Hgb Hemoglobin level Cannot be generalized to the preoperative setting where expected surgical blood loss must be taken into account in Transfusions of blood products are given to increase the amount of blood components in your body when they may be too low for your wellbeing The transfusion may be red blood cells plasma platelets or other specialized products from blood
Targeting a lower hemoglobin transfusion threshold of 7 g dL in most patients is supported by the evidence and is an important improvement in reducing unnecessary transfusions and conserving a valuable resource Blood transfusions are generally considered safe but there is some risk of complications Mild complications and rarely severe ones can occur during the transfusion or several days or more after More common reactions include allergic reactions which might cause hives and itching and fever
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Blood Component Adult Pediatric Estimated Volume Duration Effect Non bleeding 70 kg adult Dose rate Max dose and or max rate All first 15 minutes 100 mL hr 2 mL kg hr Do not exceed 100 mL hr Red Blood Cells 350mL 1 4 hrs One unit will increase hematocrit by approximately 3 or hemoglobin by 1gm dL 2 5 ml kg hr
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STEP ONE STOP THE TRANSFUSION Don t disconnect the unit though that will eventually happen at least stop the incoming flow of blood Leave the line open with saline Compare to pretransfusion sample if abnormal Poor phlebotomy technique traumatic stick drawing through IV line d Repeat ABO Rh testing 5
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Blood Transfusion Chart Decrease - Within 10m of starting cryo dyspnoea sats 64 RR30 HR125 increased BP Despite diuresis continued worsening CXR patchy consolidation in both lungs 70 yr old woman with a pneumonia and pulmonary hypertension became hypoxic 5 hours after a unit of platelets
