By: Nicola Karen Adamson, NHS Tayside, BN, DipHe
The purpose of this module is to teach the clinical RN the basics of blood, how to administer a blood/blood component transfusion safely, and the hazards of transfusion related to blood administration. This module is indicated for teaching purposes based on the fact that the NHS requires at least quarterly review of blood usage, oversight of blood transfusion practices, documentation of blood transfusion errors, and evidence of corrective actions taken. Results of one study found that "individuals' lack of knowledge and training, along with inadequate policies and procedures, were the key elements in more than 350 blood transfusion-associated deaths" (Bower & Craig, 1997) What is a Blood Transfusion?
A blood transfusion is a safe, common procedure in which blood is given to you through an intravenous (IV) line in one of your blood vessels. Blood is transfused either as whole blood (with all its parts) or, more often, as individual parts. The individual parts include red blood cells, platelets, clotting factors, and plasma. Each year, almost 5 million Americans & British need a blood transfusion. While most blood transfusions go well, mild complications can occur and serious problems may develop. The Individual Parts Defined
Red Blood Cells
-the most numerous blood cell, about 5,000,000 per microliter. Red blood cells make up about 40% of our total blood volume, a measure called the hematocrit. Their color is caused by hemoglobin, which accounts for nearly all of the red cell volume. Hemoglobin is the critical protein that transports oxygen from our lungs to the tissues. Red blood cells are normally shaped as round, biconcave discs.
Red Blood Cells
(Image obtained from http://embryology.med.unsw.edu.au/Notes/heart20.htm)
-the smallest of the three major types of blood cells, are only about 20% of the diameter of red blood cells and the normal platelet count is ~150,000-350,000 per microliter of blood. The principal function of platelets is to prevent bleeding.
(Image obtained from http://ouhsc.edu/platelets/Platelets/platelets%20intro.html)
-proteins in the blood that control bleeding.
-a pale yellow fluid that consists of about 92% water and 8% other substances, such as proteins, ions, nutrients, gases, and waste products. It is a colloidal solution which is a liquid containing suspended substances that do not settle out of solution. Most of the suspended substances are plasma proteins, which include albumins, globulins, and fibrinogen. Plasma volume remains relatively constant. Normally, water intake through the digestive tract closely matches water loss through the kidneys, lungs, digestive tract, and skin.
Plasma (which is in the yellow)
Image obtained from :
http://www.mhhe.com/biosci/esp/2001_saladin/folder_structure/tr/m1/s2/ Brief History of Blood Transfusions
1665 - The first Blood transfusions of record take place. Animal experiments conducted by Richard Lower, an Oxford physician started as dog-to-dog experiments and proceeded to animal-to-human over the next two years. Dogs were kept alive by the transfusion of Blood from other dogs.
1795 - In Philadelphia an American physician, Philip Syng Physick, performed the first known human Blood transfusion, although it was not published.
1818 - James Blundell, a British obstetrician, performed the first successful transfusion of human Blood to a patient for the treatment of postpartum hemorrhage. Using the patient's husband as a donor, he extracted a small amount of Blood from the husband's arm and successfully transfused the wife using a syringe. Between 1825 and 1830, he performed ten documented transfusions, five of which proved beneficial to his patients, and published the results. He also devised various instruments for performing Blood transfusions.
1901- Karl Landsteiner, an Austrian...