18/09/2025
General Precautions Before Infusion
1. Doctor's Order & Consent
Verify written order and informed consent.
2. Patient Identification
Use two identifiers (name, hospital ID, DOB). Cross-check patient ID with blood bag label and requisition slip.
3. Blood Bag Verification
Check blood group, Rh factor, donor number, expiry date, integrity of bag, leaks, clots, or discoloration.
Always double-check with another trained nurse/doctor.
4. Baseline Observations
Record temperature, pulse, respiration, BP, 02 saturation before infusion.
5. IV Access
Use large bore cannula (18-20G) for whole blood/PRBCs. Flush line with 0.9% Normal Saline only (no Ringer's lactate or dextrose).
During Infusion
1.Start Slowly
First 15 minutes: infuse slowly (2 mL/min) to monitor for reaction.
2. Observation
Stay with patient initially.
Monitor vitals after 15 min, then every 30 min to 1 hr, and at completion.
3. Maximum Time
Each unit should be infused within 4 hours (to prevent bacterial growth).
4. Use Filtered Set
Blood administration set with in-line filter (170-260 micron) must be used.
4. Use Filtered Set
Blood administration set with in-line filter (170-260 micron) must be used.
Specific Component Precautions
Packed RBCs -> For anemia/hemorrhage; warm if large volume/rapid infusion to prevent hypothermia.
Platelets -> Store at room temperature; transfuse as soon as received; use special platelet set; do not refrigerate.
Fresh Frozen Plasma (FFP) -> Thaw before use; check for yellow/straw color; infuse immediately.
Cryoprecipitate -> Transfuse quickly after thawing; rich in clotting factors.
If Reaction Occurs (Fever, chills, rash, dyspnea, hypotension, back pain, hemoglobinuria)
1. STOP transfusion immediately.
2. Keep IV line open with normal saline (fresh set). 3. Notify physician & blood bank.
4. Monitor vitals, provide supportive care.
5. Send blood bag, tubing, and patient's blood sample to lab for investigation.
A Key Safety Point: Never add medications or IV fluids (other than NS) to blood components.
