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Blood transfusion - 1

VOL: 97, ISSUE: 24, PAGE NO: 45

CLAIRE ATTERBURY, SPECIALIST NURSE, QUEEN ELIZABETH HOSPITAL, KING'S LYNN, NORFOLK

Blood should be treated as a drug that must be prescribed with caution. There are both indications and contraindications for giving a blood transfusion. Indications include: severe anaemia (when the oxygen capacity of the blood compromises major organs), severe haemorrhage, anaemia of chronic disorders (renal failure and cancer), haemoglobinopathies (sickle cell disease, thalassaemia). Contraindications include: megaloblastic anaemia (vitamin B12 or folate deficiency - transfusion may cause heart failure and death), iron deficiency anaemia, transfusion in healthy adults and children where use of oral iron could rectify a low haemoglobin.

Blood should be treated as a drug that must be prescribed with caution. There are both indications and contraindications for giving a blood transfusion. Indications include: severe anaemia (when the oxygen capacity of the blood compromises major organs), severe haemorrhage, anaemia of chronic disorders (renal failure and cancer), haemoglobinopathies (sickle cell disease, thalassaemia). Contraindications include: megaloblastic anaemia (vitamin B12 or folate deficiency - transfusion may cause heart failure and death), iron deficiency anaemia, transfusion in healthy adults and children where use of oral iron could rectify a low haemoglobin.

Successive Serious Hazards of Transfusion reports (the annual confidential inquiry into transfusion incidents, commonly known as SHOT), have shown that human error at the time of the collection and administration of blood is the greatest threat to the life of any patient undergoing blood transfusion. Approximately 50% of reports received by SHOT relate to single or multiple errors in the journey from the blood bank to the patient. Nurses are able to rectify this state of affairs by strict adherence to their local collection, checking and administration protocol, which should be based on the guidelines published by the British Committee for Standards in Haematology. The person collecting the blood unit should have had adequate training and MUST follow the local policy.

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