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Blood Transfusion

Introduction
A blood transfusion is the transfer of blood or blood products from one
person (donor) into another person's bloodstream (recipient). This is usually
done as a life saving maneuver to replace blood cells or blood products lost
through severe bleeding, during surgery when blood loss occurs or to
increase the blood count in an anemic patient. The following material is
provided to all patients and/or their family members regarding blood
transfusions and the use of blood products. Although in most situations the
likelihood of a blood transfusion associated with surgery is uncommon, at
times patients may require blood products. You are encouraged to discuss
your particular risk of transfusion with your doctor.
Your options may be limited by time and health factors, so it is important to
begin carrying out your decision as soon as possible. For example, if friends
or family members are donating blood for a patient (directed donors), their
blood should be drawn at least two working days prior to the anticipated
need to allow adequate time for testing and labeling. You are also
encouraged to check with your insurance company for their reimbursement
policy.
The safest blood product is your own, so if a transfusion is likely, this is your
lowest risk choice. Unfortunately this option is usually only practical when
preparing for elective surgery. In most other instances the patient can not
donate their own blood due to the acute nature of the need for blood.
Although you have the right to refuse a blood transfusion, this decision may
hold life-threatening consequences. If you are a parent deciding for your
child, you as the parent or guardian must understand that in a lifethreatening situation your doctors will act in your child's best interest to
insure your child's health and well being in accordance with standards of
medical care regardless of religious beliefs. Please carefully review this
material and decide with your doctor which option(s) you prefer.
To assure a safe transfusion make sure your healthcare provider who starts
the transfusion verifies your name and matches it to the blood that is going
to be transfused.

If during the transfusion you have symptoms of shortness of breath, itching,


fever or chills or just not feeling well, alert the person transfusing the blood
immediately.
Blood can be provided from two sources: autologous blood (using your own
blood) or donor blood (using someone else's blood
Autologous Blood (using your own blood)
Pre-operative donation - donating your own blood before surgery. The
blood bank draws your blood and stores it until you need it during or after
surgery. This option is only for non-emergency (elective) surgery. It has the
advantage of eliminating or minimizing the need for someone else's blood
during and after surgery. The disadvantage is that it requires advanced
planning which may delay surgery. Some medical conditions may prevent the
pre-operative donation of blood products.
Intra-operative autologous transfusion - recycling your blood during
surgery. Blood lost during surgery is filtered, and put back into your body
during surgery. This can be done in emergency and elective surgeries. It has
the advantage of eliminating or minimizing the need for someone else's
blood during surgery. Large amounts of blood can be recycled. This process
cannot be used if cancer or infection is present.
Post-operative autologous transfusion - recycling your blood after
surgery. Blood lost after surgery is collected, filtered and returned to your
body. This can be done in emergency and elective surgeries. It has the
advantage of eliminating or minimizing the need for someone else's blood
during surgery. This process can't be used in patients where cancer or
infection is present.
Hemodilution - donating your own blood during surgery. Immediately before
surgery, some of your blood is taken and replaced with IV fluids. After
surgery, your blood is filtered and returned to you. This is done only for
elective surgeries. This process dilutes your own blood so you lose less
concentrated blood during surgery. It has the advantage of eliminating or
minimizing the need for someone else's blood during surgery. The
disadvantage of this process is that only a limited amount of blood can be
removed, and certain medical conditions may prevent hemodilution.

Apheresis - donating you own platelets and plasma. Before surgery, your
platelets and plasma, which help stop bleeding, are withdrawn, filtered and
returned to you when you need it later. This can be done only for elective
surgeries. This process may eliminate the need for donor platelets and
plasma, especially in high blood-loss procedures. The disadvantage of this
process is that some medical conditions may prevent apheresis, and in
actual practice it has limited applications.
Donor Blood (Using someone else's blood)
All donor blood is tested for safety making its risks very small, but no
screening program is perfect and risks, such as contraction of the hepatitis
virus or other infectious disease still exist.
Volunteer blood - blood collected from the community blood supply (blood
banks). This has the advantage of being readily available, and can be lifesaving when your own blood is not available. The disadvantage is that there
is a risk of disease transmission, such as hepatitis or AIDS, and allergic
reactions.
Designated donor blood - blood is collected from the donors you select.
You can select people with your own blood type who you feel are safe donors.
Like volunteer blood, there is still a risk of disease transmission, such as
hepatitis and AIDS, and allergic reactions. This process usually requires
several days for advanced donation. It may not necessarily be safer than
volunteer donor blood.
What is it?
Blood transfusion is the process of transferring blood or a blood component
from one person, the donor, to another person, the recipient.
Who needs this procedure?
Blood transfusions are given to increase the blood's ability to carry oxygen,
to restore the body's blood volume when there has been a great blood loss,
to improve the blood's clotting ability, and to improve a recipient's immunity
to infection. Depending upon the recipient's needs, a doctor may order a
whole blood transfusion, or a blood component. Blood components include
red blood cells, white blood cells, platelets, immunoglobulins, or fresh frozen
plasma, which is the liquid part of the blood. Whole blood is usually used
with patients who have lost a lot of blood, and to make sure the body's
tissues are receiving enough oxygen. Red blood cells restore the blood's

ability to carry oxygen, such as in patients who are bleeding or have anemia.
White blood cells are given to patients with life-threatening infections that
reduce the white blood cell count. Platelets are often given to patients with
blood clotting disorders, such as hemophilia or von Willebrand's disease.
Plasma also helps with blood clotting, and is often transfused in patients with
liver failure. Immunoglobulins are the disease fighting components of blood
and are also given to build up immunity, especially in patients who have
been exposed to an infectious disease or whose antibody levels are low, such
as those with AIDS.
How do I prepare for this procedure?
If you know you will be undergoing surgery, you may want to donate your
own blood a month before your surgery. This is called an autologous
transfusion, and the blood you donate is stored at the hospital for your use
only. If you need a transfusion during or after surgery, your own blood will be
used. Or, you could ask a friend or family member with the same blood type
to donate blood specifically for you. This is called a direct donation. Many
people feel more comfortable knowing the source of the blood for a
transfusion. However, the medical community has adopted stringent
screening methods to ensure blood transfusions are extremely safe. Blood
donors must answer questions about their general health, lifestyle, and any
medical conditions that might disqualify them as donors. All donated blood is
carefully checked for viral hepatitis, AIDS, syphilis, and other viruses. No
blood is used until all test results have shown that it is safe. If you have had
allergic reactions to previous transfusions, you should make sure your doctor
is aware of this. Treatments are available so transfusions can be given to
people who have had allergic reactions.
How is this procedure performed?
All donated blood is classified by type, either A, B, AB, or O, and as RHpositive or RH-negative. To protect the recipient, the blood is matched to his
or her blood type. Before starting the transfusion, the healthcare professional
cross-matches the donor blood by mixing a drop of it with the recipient's to
make sure they are compatible. The healthcare professional will also doublecheck that the blood is intended for the recipient. Then, the donor blood is
given slowly, through an intravenous (IV) line directly into the veins. Blood
transfusions are given in units, with one standard unit of blood equaling
about one pint. During the transfusion, medical personnel watch the patient
closely for any adverse reactions. When the transfusion is complete, a

compress bandage is placed over the area where the needle had been
inserted.
People with heart disease are given transfusions even more slowly to avoid
overloading the body with fluid. People with serious diseases that haven't
responded to other treatments might benefit from a transfusion method
called hemapheresis. Hemapheresis is a process that purifies the blood by
removing blood from the patient, cleaning the harmful components from it,
then returning the purified blood to the patient. Cytapheresis is a type of
hemapheresis that removes excess amounts of certain blood cells. It might
be used to treat conditions such as polycythemia, leukemia, and
thrombocytosis. Another type of hemapheresis called plasmapheresis
removes harmful substances from the plasma. This treatment might be used
for patients with Guillain-Barre syndrome and myasthenia gravis.
What can I expect after the procedure?
After a blood transfusion, you will be carefully monitored for any adverse
reactions. An allergic reaction is indicated by swelling, rash, itchiness,
dizziness, fever, and headache. When blood is mismatched, the recipient's
blood reacts to the transfused red blood cells and destroys them. This is
called a homolytic reaction. Symptoms may include general anxiety or
discomfort, then breathing difficulty, flushing, a feeling of pressure in the
chest, and severe back pain. It is rare for these types of reactions to be life
threatening.
Definition
A hemolytic transfusion reaction is a serious problem that occurs after a
patient receives a transfusion of blood. The red blood cells that were given to
the patient are destroyed by the patient's own immune system.

Alternative Names
Blood transfusion reaction

Causes, incidence, and risk factors


Blood is classified into different blood types called A, B, AB, and O.

The immune system normally can tell its own blood cells from blood cells
from another person. If other blood cells enter your body, your immune
system may make antibodies again them. These antibodies will work to
destroy the blood cells that the body does not recognize. For example, a
person with type A blood makes antibodies against type B blood cells.
Another way blood cells may be classified is by Rh factors. People who have
Rh factors in their blood are called "Rh positive." People without these factors
are called "Rh negative." Rh negative people form antibodies against Rh
factor if they receive Rh positive blood.
There are also other factors to identify blood cells, in addition to ABO and Rh.
Blood that you receive in a transfusion must be compatible. Being
compatible means that your body will not form antibodies against the blood
you receive. Blood transfusion between compatible groups (such as O+ to
O+) usually causes no problem. Blood transfusion between incompatible
groups (such as A+ to O-) causes an immune response. This can lead to a
very serious transfusion reaction. The immune system attacks the donated
blood cells, causing them to burst.
Today, all blood is carefully screened. Modern lab methods and many checks
have helped make these transfusion reactions very rare.

Symptoms
Bloody urine
Chills
Fainting or dizziness
Fever
Flank pain or back pain
Rash
Symptoms of transfusion reaction usually appear during or right after the
transfusion. Sometimes, they may develop after several days (delayed
reaction).

Medical history interview All blood donors are asked questions about
their medical history to help determine if they can safely donate blood
without experiencing any negative health effects [1]. During the donation,
one unit of blood (approximately 500 mL or 17 fluid ounces) is removed.

Heart and lung disease Potential donors are


asked if they have ever had heart, lung, or
blood diseases. In general, people with heart
disease, heart valve conditions, irregular
heartbeat, disease of the blood vessels in the
brain, heart failure, and certain lung conditions
are not allowed to donate blood unless this has
been cleared with their healthcare provider.

Other medical conditions - Potential donors are asked if they feel


healthy and well on the day of donation.

Seizures People with a history of seizures


can donate blood, provided they have had no
seizures within a certain period of time (usually
1 to 6 months).

Recent surgery People who have undergone


recent surgery are permitted to donate blood
when healing is complete and they have
resumed full activity. However, if a transfusion
was given at the time of surgery, donation is
not allowed for one year.

Pregnancy Women who are pregnant are not


permitted to donate blood during pregnancy
and for six weeks after the pregnancy ends.

Age requirement The minimum age for blood


donation is 16 or 17 years, depending upon the
state. When allowed, 16 year olds must bring a
signed permission form from a parent. In most
cases, there is no upper age limit for donation,
although approval from the donor's physician is
required in some cases.

Weight requirement Individuals weighing


less than 50 kg (110 pounds) are usually not
permitted to donate blood. The less a donor
weighs, the greater the likelihood of having a
reaction, such as dizziness and fainting
following donation. Although reactions to blood
donation are rare, individuals weighing
between 50 and 54 kg (110 and 119 pounds)
are most likely to experience reactions.

Medical evaluation In addition to a medical history, donors undergo a


brief physical examination before donation to check for any obvious signs of
illness or conditions that would disqualify them from blood donation.

Vital signs The pulse, blood pressure, and


temperature of a donor are checked before
donation. Individuals with a fever, high blood
pressure, very high or very low heart rate (with
the exception of highly conditioned athletes
and those on beta blocker medication), or an
irregular heart beat are temporarily not
permitted to donate blood.

Blood test A small blood sample is taken


from a fingerstick and tested to check for the
number of red cells or the amount of
hemoglobin in the blood. This is done to ensure
that the donor is not anemic or likely to
become anemic or iron deficient after they
donate. Individuals with hemoglobin levels that
are too low are temporarily not permitted to
donate blood. (See "Patient information: Iron
deficiency anemia".)

Time interval until next donation Donors are eligible to donate no


sooner than 56 days after their previous donation. However, this minimum
interval can vary, depending upon how rapidly the person's body is able to
replenish their red blood cells. Some donors, especially women who have
heavy menstrual periods, will not be able to donate every 56 days because
their iron stores are not sufficient to replenish the lost red blood cells.

APHERESIS DONATION
A technology called apheresis has made it possible to collect specific
components of blood during the donation procedure. Apheresis is used to
selectively collect red blood cells, platelets (blood components that play an
important role in clotting), plasma, and granulocytes (a type of infectionfighting white blood cell).

Red blood cells Donors can give red blood


cells by apheresis once every 16 weeks. This is
less frequently than whole blood donation
because a greater amount of red blood cells
are collected during the apheresis procedure.

Platelets Donors can give platelets up to 24


times per year. About 1 percent of people have
a mild reaction to one of the substances
(citrate) that is mixed with the blood during
platelet donation; the reaction can include
feelings of numbness and tingling, muscle
cramping, and nausea. The reaction can be
treated or prevented by taking a calcium
supplement before or during the donation.

Granulocytes Donors of granulocytes may be


given granulocyte colony stimulating factor (GCSF) and/or a glucocorticoid medication called
dexamethasone on the day before donation to
increase the number of granulocytes in their
blood. Glucocorticoids are usually not given to
individuals who have diabetes, gastrointestinal
ulcers, or glaucoma. The side effects of G-CSF
and dexamethasone may include headache,
joint pain, fatigue, insomnia, allergic reactions,
and fever.

SCREENING MEASURES TO PROTECT THE RECIPIENT


Screening of blood donors helps to ensure that the donated blood is safe for
transfusion into a recipient. A variety of different measures are used for this
screening.

Elimination of payment for donation Since


the late 1970s, volunteer donors have been the
source of all whole blood and blood
components in the United States. Donors are
sometimes paid for donating plasma that is
used to manufacture other blood products.
However, to protect the recipient, these
products undergo additional purifying tests.

Screening for infections


Human immunodeficiency virus (HIV) The human immunodeficiency
virus (HIV) is the virus that causes AIDS. A variety of measures are used to
screen donors for potential or actual HIV infection, including questioning the
donor about any signs or symptoms of HIV and behaviors that increase the
risk of HIV.
People who want to be tested for HIV or other sexually transmitted infections
should NOT donate blood for this purpose. Even though donated blood is
tested for HIV, the tests are not perfect; a person who might have been
exposed to HIV could transmit the virus to a recipient if they donate blood.
Free and anonymous HIV testing is available elsewhere (see
www.hivtest.org).
Hepatitis Hepatitis is an infection that causes inflammation of the liver.
Blood donors are routinely screened to determine if they have or have been
exposed to hepatitis.

People who have had viral hepatitis (A, B, or C)


or hepatitis of unknown origin after their 11th
birthday are permanently disqualified from
donating blood.

People who have ever had a positive test for


hepatitis B surface antigen (a marker for
hepatitis B) are permanently disqualified from
donating blood.

People who have had sexual contact or have


lived in the same dwelling (eg, house,
dormitory) with someone who has hepatitis (A,
B, or C) are disqualified for 12 months after

their last exposure to that person, depending


upon the particulars of the exposure.

People who have received a blood transfusion


are not permitted to donate blood for 12
months after the date of transfusion.

In many states, people who have received a


tattoo or a body piercing are not permitted to
donate blood for 12 months. In some states,
where these industries are carefully regulated
by state law to ensure that the procedures are
sterile, earlier donation may be permitted
without the need for any waiting period.

Parasitic diseases Blood donors are routinely asked questions about


possible exposure to several parasitic diseases that can be transmitted by
blood transfusion.

Malaria Transfusion transmitted malaria is


common in some parts of the world, but is
extremely rare in the United States. Donors
who have had malaria are not permitted to
donate for three years after they become free
of symptoms. Travelers to regions where
malaria occurs are not permitted to donate
blood for one year after they leave the area,
provided they have not had symptoms of
malaria. Immigrants from or residents of
countries where malaria is common are not
permitted to donate for three years after their
departure from that country. (Residency is
usually defined as living in the country for at
least five years.)

Chagas' disease and babesiosis Transmission


of Chagas' disease (American trypanosomiasis)
by transfusion is rare in the United States.
Blood donors are asked if they have ever had

Chagas' disease and most donated blood is


tested for Chagas' disease.
Transmission of babesiosis (a malaria-like illness spread by ticks) by
transfusion is uncommon. Blood donors are asked if they have ever had this
disease.

Creutzfeldt-Jakob disease (CJD) and variant CJD


Creutzfeldt-Jakob disease (CJD) is a rare but
fatal neurologic disease. Variant CreutzfeldtJakob disease (vCJD) is a somewhat similar
disease that first appeared in the United
Kingdom (UK) in 1996. Affected individuals
may have no symptoms of CJD or vCJD for
many years.

To date, there have been no reported cases of transfusion-related


transmission of CJD and only four reports of probable transmission of vCJD in
the UK. Despite this extremely small (vCJD) risk, donors who meet one or
more of the following criteria are not allowed to donate:

Have spent 3 cumulative months in the UK


from 1980 to1996, or

Have spent 5 cumulative years in Europe


from 1980 to present, or

As current or former US military personnel,


civilian military employees and their
dependents, have lived for 6 months at US
military bases in Northern Europe from 1980 to
1990 or elsewhere in Europe from 1980 to
1996, or

Received a blood transfusion in the UK or


France between 1980 to present, or

Injected bovine (from cows) insulin from the UK


or other countries with a history of mad cow
disease (bovine spongiform encephalopathy)

Bacterial infection Bacteria can get into donated blood if a donor has a
bacterial infection, if bacteria on the skin gets into the blood from the needle
stick, or if there is a skin infection near the location where the blood is
drawn. To reduce the likelihood of bacterial contamination of blood, the skin
around the site is carefully examined and cleaned before the needle is
inserted.
Donors who have a fever, who do not feel well, or who are taking oral
antibiotics (except for acne) are not permitted to donate blood. These
restrictions also apply to individuals who are banking blood for their own use
(see 'Autologous blood donation' below).
Other medical conditions In order to protect the recipient against noninfectious complications, the donor is evaluated for certain medical
conditions before blood donation.

Cancer There have been no reported cases


of the transmission of cancer by blood
transfusion. However, because such
transmission is theoretically possible, donors
are screened for a history of cancer.

Donors who have had cancer of a solid organ or tissue (such as the lung,
liver, breast) are permitted to donate if they have been symptom-free and
cancer-free for a defined period of time, usually two to five years.
Donors who have had blood cancers (such as leukemia or lymphoma) are
permanently disqualified from donating.
Donors who have had a superficial cancer that has been completely removed
by surgery (such as basal cell cancer of the skin or early cervical cancer) can
donate blood without any waiting period.

Hemochromatosis Individuals with


hereditary hemochromatosis (a condition in
which frequent removal of blood is the
standard treatment) can donate their blood for
transfusion if they meet other criteria for being
a donor and if the blood bank has met certain
regulations from the Food and Drug
Administration (FDA). There is no risk of
transmitting this condition to the recipient.

(See "Patient information: Hemochromatosis


(hereditary iron overload)".)
Medications Most medications taken by donors do not pose a risk to
recipients. However, five drugs are known to cause birth defects and are
considered during donor screening:

Etretinate (Tegison), used for severe psoriasis

Acitretin (Soriatane), also used for severe


psoriasis

Isotretinoin (Accutane), used for severe acne

Finasteride (Propecia, Proscar) used for


benign prostatic hypertrophy and hair loss.

Dutasteride (Avodart) usually given for


prostatic enlargement

Donors who have taken isotretinoin and finasteride are asked to wait one
month after the last dose before donating blood, donors who have taken
dutasteride are asked to wait six months, and donors who have taken
acitretin are asked to wait three years. Individuals who have taken etretinate
are permanently disqualified from donating blood.
People who took aspirin or aspirin-containing medications within the previous
48 hours are allowed to donate whole blood but are not allowed to donate
platelets by apheresis. People who took warfarin (Coumadin) are generally
not allowed to donate blood for approximately 7 days after the last dose. The
reason for this is that this blood does not contain sufficient quantities of
clotting factor.
Laboratory testing of donated blood After a unit of blood has been
donated, the blood is tested in a laboratory for infectious diseases that can
be transmitted by blood transfusion. These include tests for HIV, hepatitis B,
hepatitis C, human T-lymphotropic virus (HTLV), West Nile virus, syphilis, and
in most areas, Chagas' disease. (See "Patient information: West Nile virus
infection".)
Confidential unit exclusion (CUE) The confidential unit exclusion (CUE)
process allows someone who has donated blood to confidentially indicate

that his or her blood should not be given to others. This process protects
individuals who feel pressured to donate at the workplace or during
community blood drives. Donors are asked to place a bar code sticker on
their donation form, indicating if their blood should be used. This is done
after the interview, but before donation. This procedure is used by some, but
not all, US blood banks.
Registry of deferred donors A registry of deferred donors contains
names of individuals who have been disqualified from blood donation in the
past. Some donors in the registry have infectious diseases such as hepatitis
B or HIV infection. Theoretically, it is possible that an individual with one of
these diseases could have a positive test result at one time but negative test
results at a later time.
Other donors in the registry have provided information in the past that
disqualified them from blood donation. A donor's name is usually checked
against this registry before and after donation. The reason for the deferral is
not usually available to staff at the collection facility.
Telephone callbacks After donating blood, donors are given a phone
number so that they can call the donation center to report any factors that
may affect the use of their blood or to report symptoms of infections in the
first days after donating (such as symptoms of upper respiratory tract
infection or gastrointestinal illness). Such reports will be evaluated and the
unit of blood may be destroyed.
RISK OF INFECTION FROM A TRANSFUSION
Safety measures, such as improved screening tests, have dramatically
reduced the risk of acquiring a viral infection from a blood transfusion.
Recent estimates suggest the following risks of developing certain infections
after receiving a unit of blood:

One in 58,000 to 269,000 for hepatitis B

One in 2 million for hepatitis C

One in 2 million for human immunodeficiency


virus (HIV)

One in 2 million for human T-cell


lymphoma/leukemia virus (HTLV)

AUTOLOGOUS BLOOD DONATION


Autologous blood donation is when a donor donates blood for themselves
several days to six weeks ahead of a scheduled surgery, when blood might
be needed. Autologous blood donation reduces the risk of most, but not all,
infectious complications of blood transfusion.
POTENTIAL COMPLICATIONS OF BLOOD DONATION
Most people who donate blood do not have any complications that require
medical care. The most common complications include bruising or soreness
at the needle site and fatigue.
A small percentage (2 to 5 percent) of people feel faint and/or pass out
before, during, or after donating blood. This is more common the first time a
person donates and in people who are younger. Drinking a 16 ounce (473
mL) bottle of water before donating may reduce this risk.
Preparation for Blood Transfusion
1.

Before a blood transfusion is performed, the doctor will order a blood


specimen to confirm the patient's blood type and compatibility with the
blood being donated. This test is done even when the patient is donating
his own blood. This is done to ensure the patient's safety and health.
Transfusion Procedure

2.

Before the transfusion begins, the patient must sign a consent form.
The doctor will then order the patient to take medications, such as
antihistamines and acetaminophen, before the transfusion. Before the
transfusion begins, two nurses will check the patient's identity. The nurse
performing the transfusion will then insert an intravenous line into the
patient's arm.
Nurse's Responsibility During Procedure

3.

The nurse handling the transfusion has a number of responsibilities to


ensure that the procedure is performed correctly and to ensure the
patient's safety and health. Before, during and after the transfusion, the
nurse will check the patient's temperature, pulse and blood pressure ,
and will check for any signs of adverse reactions to the transfusion. While
reactions are rare, they are monitored. Symptoms for adverse reactions
include breathing problems, chills, fever, itching/hives, rash, nausea,

lower back pain, apprehensive feelings, tingling or numbness, heat, pain,


or swelling at the site where the IV is inserted. Patients are urged to keep
the nurse abreast of any symptoms they experience.
What Patient Can Expect During Transfusion
4.

Blood transfusions are relatively simple procedures that can up to 11/2 to two hours, depending on the amount of units being transfused into
the patient. Generally, most transfusions require at least two to three
units. The patient is allowed to eat and drink during the procedure and is
able to use the bathroom with assistance from the nurse.

What Are the Risks Associated with Blood Transfusions?


The Food and Drug Administration (FDA), The American Association of Blood
Banks (AABB), and The Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) regulate the process of obtaining, storing, preparing,
and testing of blood. These organizations are responsible for ensuring a safe
blood supply.
Blood donors must go through an extensive screening process before they
are able to donate blood. After blood is drawn, it is tested for blood type, RH
factor, as well as for antibodies. Multiple individual screening tests are
performed for evidence of infection and viruses. With this extensive testing,
the chance of receiving a unit of blood containing the Human
Immunodeficiency Virus (HIV) or hepatitis C virus is around 1 in 2 million, and
less than 1 in 200,000 for hepatitis B.1
How Do I Prepare for a Blood Transfusion?

You can expect that your doctor will order a blood specimen to
confirm your blood type and to check compatibility with the
donor unit. Compatibility testing (also referred to as cross
matching ) is done even if you have donated your own
(autologous) blood.

Check with your doctor about how much time to plan for your
blood transfusion procedure. Each unit of blood usually
transfuses over 1 to 2 hours. Some transfusions are for 2-3
units. You may be here for several hours depending on what your

doctor has ordered for you. Please arrange your transportation


accordingly.
Where Do I Go for my Blood Transfusion?

If You Are a Patient in the Hospital: Your nurse administers


your blood transfusion at your bedside and monitors you
throughout the entire procedure.

If You Are a Patient Coming from Home to the Pacific


Campus: Blood transfusions are given in our Ambulatory Care
Unit (ACU), 2351 Clay Street, on the 6th floor. Register with the
admitting staff in the Ambulatory Care Unit when you arrive.
Parking is available in the garage located at 2405 Clay Street
(corner of Clay and Webster Streets).

If You Are a Patient Coming from Home to the Davies


Campus: The staff will contact you the day before your blood
transfusion procedure. Proceed to either:
1. North Tower - 4th floor, Ambulatory Care Unit (ACU),
Nurses' Station, or
2. South Tower - 1st floor, Outpatient Infusion Services
(OIS), Room 151A
Parking is available in the garage located at Castro and Duboce
Streets.

What Can I Expect During a Blood Transfusion?

The nurse will ask you to sign a consent form verifying that you
understand and agree to the procedure as explained by your
doctor.

You will be positioned comfortably for this procedure. The nurse


will insert an intravenous line (IV) in your arm.

Your doctor may order medication for you to take prior to the
transfusion. The nurse will explain the reason and action of the
medications.

For patient safety, 2 nurses will verify your identity by checking


your I.D. band with the unit of blood.

The nurse will start the transfusion and monitor your


temperature, pulse, and blood pressure before, during, and after
the transfusion.

Also, the nurse will observe for signs of a reaction to the


transfusion(s). Reactions to blood transfusions are rare.
Symptoms may include shortness of breath, chills or fever (101F
/ 38.3C or above), itching/hives, rash, nausea, lower back pain,
feelings of apprehension, tingling or numbness; heat, pain, or
swelling at IV site. Please report these symptoms immediately to
your nurse.

You may eat and drink during this procedure. With the assistance
of a nurse, you may get up and go to the bathroom.

What Should I Watch Out for After I Go Home?

You may resume your normal activities.

Continue your usual diet and medications.

Be alert for symptoms of a reaction after you go home. Call your


doctor immediately or go to the Emergency Room if you
experience any of the following symptoms:

Shortness of breath

Chills or fever (101F / 38.3C or above)

Itching/hives, rash

Nausea

Lower back pain

Feelings of apprehension

Tingling or numbness

Heat, pain, or swelling at IV site

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