Blood Administration: Procedure (Nursing)

00:04 Now, most agencies state that you need to get a baseline vital signs.

00:09 So what I mean by this is before we even start the blood, you get a full set of vital signs, because, if there's changes in this such as hypotension or tachycardia, we need to know what the patient's normal resting vital signs are.

00:25 Now once we've obtained this set, we can assess the patient's respiratory and cardiac status again, to get a baseline understanding of where the patient's at before we start the blood.

00:36 Now we can remove our gloves, perform our hand hygiene, and then don new once.

00:42 Now once we've donned our gloves, now we want to use the two-person verification process to make sure we're going to check that blood product and it's going to the right patient.

00:54 So, let's take a look at this verification process.

00:58 As you can see here, there's a lot f points.

01:01 Now, this is there to ensure safety, that we're giving the right type of blood to the right patient, because you can imagine there's a lot of horror stories out there about all the blood incompatibilities, so this is there as a safety net for us to make sure that we are ensuring the safest process for the patient.

01:21 So we go to verify the blood.

01:23 We've got to make sure those who are verifying it are qualified to do so.

01:27 So this is typically going to be two RNs at the bedside.

01:30 Now it's important again that we're going to stay at the bedside with the client so you've got to arrange your care to know that there's going to be intensive monitoring, especially when we first start the blood.

01:42 Then we've gotta ensure that we matched the actual blood, that that is the correct type, and the right blood product for the healthcare provider's order.

01:50 Now once we've done that, we're going to verify the match between the name and date of birth on the client's actual wristband to that information on the blood bag that we got from the blood bank.

02:02 Now when we're checking this process, there's a specific blood bag verification number we've gotta check the blood type and Rh compatibility, and we've got to make sure that that blood has not expired.

02:17 Now, once we've gone through this verification process, then we can sign the transfusion form, in on either paper or the electronic healthcare record.

02:28 Now, once this verification process is actually complete, now we can actually prime the administration tubing but we're going to prime it with saline first.

02:38 Now, once we've primed it all the way to the end with the saline, we want to spike our blood product.

02:45 Now, here's a tip for you, this is what I personally like to do.

02:49 Sometimes, once you spiked the blood product, I actually like to spike the blood all the way to the end of the tubing.

02:57 That way when I start the transfusion itself, I don't delay.

03:02 If there's any potential for blood reaction.

03:05 When I'm there with the patient, and I start monitoring, I know the patient's getting the blood.

03:11 So then make sure that you placed the administration tubing into the infusion pump itself.

03:17 And we want to use that alcohol pad to scrub the hub of the peripheral IV tubing.

03:22 Now don't forget, patency is important so we're going to flush that peripheral IV with that 10 mL saline syringe.

03:30 And we're going to check here that there's no irritation, or leaking at the site.

03:34 And that IV is patent, and working well for our blood products.

03:39 Now, once we've checked that IV, we can attach the administration set to the peripheral tubing and then label, this is a good idea to maybe label the tubing near the client so we know quickly that that's blood.

03:52 However, many times you can see clearly that this is the dark red, the blood that's going right to that site.

03:58 Now, once we begin the infusion, many times you'll see policies say to use a low and a slow rate to transfuse the blood.

04:07 This could be anywhere from about 30-50 mLs per hour.

04:11 We do this to slowly introduce the blood and check for any transfusion reactions.

04:17 It's really, really, really important that once we start that blood, we stay with the client for the first 15 minutes and we do not leave that bedside.

04:29 So this is really important because we've got to monitor for any of those transfusion reactions.

04:34 So if you recall, this could be chest pain, shortness of breath. This could be fever, hives.

04:40 There's a numerous amount of transfusion reactions, so make sure you stay with your patient.

04:46 Now after that first 15 minutes, it's really important to reassess the client's vital signs.

04:52 The respiratory and their cardiovascular status.

04:55 Now, after that first 15 minutes, when we check that vital signs, if you remember, we could be looking for things such as hypotension, tachycardia or fever and that would indicate a possible transfusion reaction and again, any of those abnormal signs, you need to stop the reaction.

05:14 Now every agency's a little bit different, but it's pretty standard that after the first 15 minutes, that you initiated the blood transfusion, you check vital signs.

05:25 But the frequency there after is very specific to the agency protocol so make sure that you check yours.

05:33 Now we can increase the infusion rate as prescribed and as the patient tolerates it.

05:39 Now, one more thing to note.

05:41 Stop the infusion, again, if any of those signs of reaction occur, but don't forget to check the IV site because infiltration, leaking around the site or pain can occur at the IV site with blood administration.