Blood Transfusion Safety

Introduction

Almost 120 million units of blood are donated each year. Nevertheless, more is needed to satisfy the global demand. Numerous patients in need of transfusion require more convenient access to safe blood and blood products. Frequent donations are necessary to ensure a continuous supply for those in need. Despite the requirement globally, donation rates vary worldwide. Some developed nations notice up to seven times more additional donations than low-income nations.

Blood transfusions are required for various health conditions, including anemia (a disease in which there is a shortage of sufficiently healthy red blood cells to carry sufficient oxygen to the body's tissues), difficulties during pregnancy and delivery, and extreme blood loss due to mishaps, trauma, and surgery. They are also frequently used in patients with disorders such as sickle cell disease (a condition that impacts hemoglobin, the molecule in red blood cells that supplies oxygen to cells throughout the body) and thalassemia (an inherited blood condition induced when the body does not produce an adequate protein called hemoglobin, an essential element of red blood cells), and for derivatives to cure hemophilia (a bleeding disorder in which the blood does not clot adequately). Supporting safe practices during the collection, holding, and utilizing donated blood is collectively named hemovigilance. These practices protect the whole blood transfusion chain and are used to normalize blood usage in healthcare.

What Is a Blood Transfusion?

A blood transfusion is a standard medical practice in which donated blood is delivered to an individual via a thin tube attached to a vein in the arm. The potentially life-saving approach can substitute for blood loss because of surgery or injury. A blood transfusion is helpful in conditions where the body stops synthesizing blood or some of the blood's elements. Blood transfusions are not complicated procedures. When difficulties do arise, they are normally benign. Individuals require blood transfusions for numerous reasons, such as surgery, damage, illness, and bleeding disorders. Blood has several elements, including:

• Red blood cells carry oxygen and assist in the release of waste products.

• White blood cells help the body to combat illnesses.

• Plasma is the fluid portion of the blood.

• Platelets aid in adequate blood clotting.

A transfusion helps meet the deficiency in blood and its components, with red blood cells being the most common constituent transfused.

What Are the Indications for Blood Transfusion?

1. The transfusion of blood and its components is required to raise hemoglobin and oxygenate tissues to sustain sufficient blood volume and avoid ischemia (a disease in which the blood flow is limited or decreased in a portion of the body) and hypovolemic shock (a condition in which the blood or fluid loss makes the heart incapable of pumping adequate blood to the body) and to increase platelets, clotting elements, and different plasma proteins to required levels.

2. Hemoglobin and hematocrit (percent of red blood cells in the blood), with signs and symptoms of anemia (a disease in which there is a shortage of sufficient healthy red blood cells to carry requisite oxygen to the body's tissues), have been the standard designations employed to define the necessity for transfusion of red blood cells. Hemoglobin of fewer than ten grams per deciliter or a hematocrit of lower than 30 percent has traditionally been considered the standard indicator for transfusion.

3. The transfusion status may be more elevated in specific diseases such as sepsis (overactive and severe reaction of body from infection) with insufficient oxygen supply, acute coronary syndrome (group of diseases linked with sudden, less blood flow to the heart) with ischemia (a disorder in which the blood flow is limited or decreased in a portion of the body), and surgical bleeding or particular age group such as the elderly.

4. Platelets are generally transfused when patients have a lower platelet count (thrombocytopenia) or have platelets that are non-functioning due to medicines or pathological conditions.

5. Plasma can be employed to substitute clotting factors in typical coagulopathies (a disorder in which the blood's capacity to form a clot is impaired) like liver disorder when bleeding is present), the reversal of warfarin effect (when clotting concentrates are not available). It can cure diseases such as thrombotic thrombocytopenic purpura (a condition in which blood clots (thrombi) form in tiny blood vessels in the body). It is occasionally used as a substitute fluid in plasmapheresis (a procedure to extract and substitute a patient's blood plasma). It is used in clotting factor shortages where certain factors are not available.

6. Cryoprecipitate is a plasma blood derivative. Used during emergencies as a coagulation factor in inherited defects and used only when certain factors are unavailable. It can reload fibrinogen in developed coagulopathies such as disseminated intravascular coagulation (a disorder in which blood clots form throughout the body, choking small blood vessels) and during trauma or delivery.

What Are the Complications Associated With Blood Transfusion?

The complications associated with blood transfusion are listed below:

• Allergic Reactions: Some individuals have allergic responses to transfused blood, even when given the correct blood. These patients' symptoms include hives (skin response that induces itchy bumps).

• Fever: Getting a fever after a transfusion is not severe. A fever is the body’s reaction to white blood cells in the blood. Nevertheless, if the patient encounters nausea (vomiting) or chest pain it is an indication of extreme response.

• Acute Hemolytic Reaction: An acute hemolytic response is a very severe but infrequent response driven by a patient's body destroying the transfused red blood cells. The attack initiates a chain of events resulting in kidney damage. This condition usually occurs when the donor's blood does not match the recipient’s blood. Symptoms present as nausea, fever, colds, chest and lower back aches, and dark urine.

• Blood Infections: All donated blood is screened for possible viruses, bacteria, and parasites. However, in some cases, though rare, contamination does occur and infection is a possibility after a transfusion.

What Are the Measures for Safe Blood Transfusion?

The measures taken for a safe blood transfusion are listed below:

1. The patient should be an ideal candidate for the transfusion procedure. The patients should be asked to display their full name and date of birth whenever required. For patients incapable of taking decisions like pediatric, unconscious, or of unsound mind, consent should be obtained from parents, designated friends, or someone who has been given the power of attorney or legal guardian. Identity details should match the band's details (or be similar). All paperwork associated with the patient must match at every point to the individual bar.

2. If possible, patients (and youngsters, those with parental commitment, and guardians) should be explained the dangers, advantages, and options of transfusion demonstrated to them conveniently and understandably.

3. The transfusion documentation must include the following details: patient identity, date of transfusion, amount or the number of units to be saturated, speed or time of transfusion, and unique conditions (for example., irradiation, cytomegalovirus negative).

4. The blood specimen collection from the patient into the sampling tubes and specimen labeling must be the same. The same healthcare professional should be in charge of everything as in one patient and one qualified and competency-assessed healthcare employee. Sampling tubes should be labeled separately, and the individual gathering the sample should sign the submission form.

5. Before the collection, confirm the patient is prepared to begin transfusion. Only experienced and qualified attendants should collect blood from the laboratory or refrigerator. Attendants can verify patient identity documentation with the blood component tag. The sample should be delivered to the clinic without any halt or break.

6. The last examination must be performed next to the patient by a professional and qualified healthcare expert who also allocates the component. All constituents are delivered through a blood administration kit.

Conclusion

Nurses and experienced attendants carry out the organizing, screening, changing of blood, and observing blood donors in a secure and standardized method throughout the donation procedure. A laboratory team is necessary for the safe handling of blood samples. Clinicians help with medications for those individuals with allergic responses during blood transfusions, and gentle allergic transfusion responses, assisting with medications so that the transfusion can continue. Effective communication with the various responsible authorities and patient supervision is required for this life-rescuing approach to be adequate and secure for patients. Transfusion safety administrators and connected specialists play a vital role in observing and practice of blood transfusion standards.