blood transfusion

Nurses General Nursing

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when do you use leukodepleted blood versus untreated blood? what is the difference and what are technology risk? For example, in patients with anemia or for OR?

Specializes in Adult/Ped Emergency and Trauma.

When it is ordered!!!! What do I win??:)

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Specializes in Med/Surg, Oncology, Epic CT.
When it is ordered!!!! What do I win??:)

WINNER! You get a gold star! gold_star.gif

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Specializes in Adult/Ped Emergency and Trauma.

SWEET!!!:)

(I didn't even prepare a speech)

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Specializes in Infusion Nursing, Home Health Infusion.

OK have to answer now

Leukocyte depleted blood is blood that has the majority of leukocytes removed or reduced. Years ago we used to do this at the bedside with very specialized filters that were difficult to prime now in the US this is usually pre-filtered before release from the Blood Bank. Blood without the leukocytes reduces some of the pesky transfusion associated reactions. It helps prevent HLA alloimmunization,platelet refractoriness,reduction of transmission of CMV virus and febrile non-hemolytic reaction. Many types of patients benefit from removal of the leukocytes such as those with Cancer,kidney disease,the immunocompromised and those at risk for HLA alloimmunization. If your patient has experienced febrile reactions from previous blood transfusions they would benefit from having this type of blood.

Irradiated Blood products. This is blood that has been exposed to radiation. When blood is irradiated it prevents lymphocytes from replicating. This is used to prevent graft versus host disease (GVHD) in patients such as those with leukemia and non-Hodgkins Lymphoma.

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Specializes in Psychiatry.

Dear iluvivt,

Thank you for the information. Having been out of touch with blood transfusions and related procedures, that was a great refresher's course. Thanks for sharing. Appreciate it.

AL.

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I distinctly remember "leuko-reduced" being an option to click when placing an order for PRBCs in the computer. In fact, it reminds me of a rather uncomfortable episode....

In my pre LPN days I was a sort of "Aide/ward clerk" for an oncology floor in a hospital. I did secretary work and hands on care aide duties. I was hired in as a high school grad with zero healthcare experience. I got a week orientation. And after that, one of my job duties was to enter Phys orders into the computer. A frequent order was PRBCs. A doctor ordered 2 units PRBCs on a leukemia pt. He didn't write leuko-reduced or irradiated. So I didn't click on those boxes. After the pt received the transfusion I got screamed at for "ordering wrong". I was told I should have known. Huh? I wasn't a nurse, had never taken anything beyond HS biology. I didn't even really understand what leukemia was, beyond a "blood cancer". Hospitals put uneducated, unlicensed people in positions were they have way too much responsibility just to save a buck....

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Specializes in Psychiatry.

Hi Brandon, Thank you for sharing that nightmarish experience. I am just amazed that a nurse was not required to sign-off on that data-entry made by you in order to authenticate the order. That was the system's failure, not yours. In every hospital that I have worked (which are not too many), orders entered by a unit clerk must be acknowledged by a RN before a phlebotomist is dispatched from the lab.

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Specializes in Hospice.

I have not ever NOT given leuko reduced rbcs.....its the norm

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Specializes in Infusion Nursing, Home Health Infusion.

Where I work it is leuko-reduced pre-storage. In Canada and Europe I think they do this by law. In the US it is only done by request or each institution can decide if they want all products to to be leuko reduced. last I heard it is not standard across the US. I will check into to it and see what I can find. it would be found in the AABB technical manual ,which I do not have a copy. So you blood bank may actually only accept this kind of blood and you may not even no it. it is really good to know especially if you work in an area in which frequent blood products are administered. I personally have seen a reduction in transfusion related reactions because we do this.

I have to study this all of this to pass the CRNI test and when you star tlooking at the material it quite extensive. I never even knew what TRALI was and never even heard of it until I started reading about blood products and potential reactions.

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sorry for the late reply. this isnt an assignment. it happened here in my workplace, this homecare center in india. the order was to transfuse leukodepleted blood to this old guy who has been in our unit for quite some time. the blood unit was divided into two to prevent congestion i guess. this guy also has thalassemia. the blood came it was checked by the doctor. it was checked by the nurse and co nurse. it was hooked as side drip. later that we realized that it was not reduced with wbc. what harm would it have done to the patient. nothing happened to him though.

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Why is it so wrong for a student to get an answer here?

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there was a time when we asked questions and it was a nice discussion of opinion. now it's all is this an assignment??

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