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Blood Transfusion Service

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  • A 32 years old man(known case of acute leukemia) refer to hospital due to anemia (Hb:6.5) and thrombocytopenia

(PLT:8000)

  • What do you do?

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Hospital Blood Bank

  • A division of a hospital laboratory where:
  • Storage of blood product occurs
  • Proper testing is performed to reduce risk of transfusion related events (compatibility testing)
  • Blood donation processing, depending on capabilities of facility. 

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  • Patient identification
  • Sampling
  • Blood grouping
  • Ab screening
  • Cross match

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Forward blood grouping

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Forward blood grouping

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Backward blood grouping

  • Serum of the recipient add to A cell and B cell

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Rh typing

  • Anti D

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Blood grouping

​

​

Anti A

Anti B

A1 cell

B cell

Anti D

interpretation

0

0

4+

4+

0

?

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Cross match

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Cross match

  • Serum of the recipient add to RBC of donor

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Ab Screening & Identification(Panel)

7

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Packed cell

  • Centrifugation of whole blood and removal of plasma
  • Shelf life: 35 DAY
  • Storage: 1-6c
  • Extra refrigerator:

30 minute

​

​

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  • A 32 years old man(known case of acute leukemia) refer to hospital due to anemia (Hb:6.5) and thrombocytopenia

(PLT:8000)

  • What do you do?

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PLATLET

  • VOL:

50-70cc

  • RBC:

0.5%Hct

  • S.L:

5 day in 20-24c

  • 1u :

INC. 5000/microlit.

​

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Patient preparation

  • Physician order
  • Patient identification
  • History
  • Patient education
  • Unusual symptom

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  • Transfusion form
  • Baseline vital sign
  • Monitoring
  • Using filter
  • Blood warmer
  • Speed of infusion
  • 2ml/min for first 15 min.

​

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  • In general, it is desirable to complete a red cell transfusion within 2 hours and a platelet or plasma transfusion within 30–60 minutes.
  • Any transfusion should be completed within 4 hours of initiation

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  • After transfusion the patient is complicated with fever and chills.
  • Nausea , vomiting, pain, bleeding, and hemoglobinuria

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Common Signs &Symptoms of Transfusion Reaction

--Fever

-Chills with or without rigors

-Respiratory distress

-Hyper- or hypotension

-Abdominal ,chest,flank or back pain

-Pain at the infusion site

-Skin manifestations

-Jaundice or hemoglobinuria

-Nausea/vomiting

-Abdominal bleeding

-Oliguria/anuria

7

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TRANSFUSION REACTION INVESTIGATION

  • Stopped transfusion
  • IV line
  • Notified to physician and blood bank
  • EDTA sample
  • Clot sample

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  • Compare blood bag label with patient identification
  • ABO group
  • Cross match
  • Direct coombs
  • Bacteriology

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  • Urine analysis
  • Bilirubin
  • PT,PTT,PLT
  • Fibrinogen
  • D-Dimer
  • Serial Hb /HCT

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  • A 50 years old man is referred to hospital due to liver failure. Laboratory tests revealed abnormal PT and PTT tests.
  • what do you do?

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FFP

  • VOL:

200cc

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FFP

  • S.L : freeze

1y IN -18c or lower

  • Thawed

24h IN 1-6c

  • 1ml:1u C.F
  • Dose:10-20 ml/kg
  • CROSS MATCH

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MD-3-49

39

30/11/49

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MD-3-49

40

30/11/49

plasma

No

No

Yes

Yes

Yes

No

Yes

No

Yes

No

Yes

Yes

Yes

Yes

No

No

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