Preparation Steps
What IV solution is compatible with blood products?
0.9% Normal Saline (NaCl)
What are common signs of a mild allergic transfusion reaction?
Itching, rash, hives - without respiratory distress
What's the maximum time a unit of PRBCs can hang?
4 hours
How should the transfusion plans be adjusted for a patient with CHF?
Who can verify blood products at the bedside?
Two regulated healthcare professionals (RN/LPN), student nurses, ESN
Within how many minutes must a transfusion be started after leaving TMS?
Within 30 minutes
A patient reports chills and fever 10 minutes into the transfusion. What is your priority action?
Stop the transfusion
How often should vital signs be taken during a transfusion?
15 minutes after initiation, every hour, within one hour post transfusion
What is the protocol for multiple infusions?
Use new tubing after every 2 units or after 4 hours
What agency sets blood safety standards in Canada
Canadian Blood Services (CBS)
For bedside check #2, what does the nurse bring to the bedside for comparison and verification?
BPV, MRP order, blood bag, compatibility tag
Define transfusion-associated circulatory overload (TACO)
A condition caused by rapid or excessive transfusion volume, leading to pulmonary edema
What should you do if the transfusion exceeds 4 hours?
Stop the transfusion and discard the remaining blood
What happens if a patient refuses a blood transfusion?
Respect the decision, provide education, and notify the MRP
What do you do if you find an error during the cross-checking process?
Stop the process and ensure the error is corrected by the appropriate department:
Patient identity - facility registration
Consent and orders - MRP
TMS ID, blood component/product, TMS doc - TMS
What verification is required for the second bedside check before starting a transfusion?
Two nurses must verify patient ID, confirm consent, blood product, patient blood group, compatibility, blood expiry date, TMS wrist band, blood product, lot number, and visual inspection of blood
You suspect your patient is showing signs of a mild allergic reaction to the transfusion. What are your next steps?
Stop the transfusion, begin NS infusion at TKVO, assess vital signs, notify the MRP
At what rate will you infuse the blood during the first 15 minutes?
50-100ml/hr
What should you do with any leftover blood or tubing after a reaction?
Send blood and tubing to the lab for investigation
When picking up blood from TMS, what do you need to bring?
2 unique patient identifiers, amount and type of blood component (MRP order)
What baseline data must be documented before starting a transfusion?
Vital signs (TPR, BP, SpO2), respiratory and cardiovascular assessment, VAD assessment, consent has been signed by physician
Define transfusion-related acute lung injury (TRALI)
A severe, immune-mediated reaction causing non-cardiogenic pulmonary edema within 6 hours of transfusion
After a transfusion of PRBCs is completed, what should the nurse do with the filter tubing set?
Flush the tubing with 30-50ml 0.9% normal saline and then discard it
When should you immediately notify the MRP?
At any sign of reaction
Recommended infusion time is 1.5-2 hours, with a maximum of 4 hours