Blood Transfusion Types

About this course

A blood transfusion is a common medical procedure that is required when an individual experiences excessive bleeding due to an injury or during surgery. It is also given when the body cannot make blood properly on its own. When this occurs, donated blood is transfused to the individual, as their own blood level is insufficiently low to carry oxygen around the body. This life-saving procedure, although safe, has multiple complications that should be considered by practitioners. This course will overview the different blood components, transfusion types, and the role of healthcare providers during the transfusion process.

Learning objectives

• Identify the four blood groups
• Understand the different types of blood components available for transfusion
• Review the testing process for the various blood components prior to transfusion
• Implement to steps for patient verification prior to blood product transfusion
• Review the protocol for massive transfusion

Course outline

18 sections · finish in any order across devices

1. 1

   Introduction

   A blood transfusion is a common medical procedure that is required when an individual experiences excessive bleeding due to an injury or during surgery.1 It is also given when the body cannot make blood properly on its own.3 When this occurs, donated blood is transfused to the individual, as their o

   4 min

2. 2

   Understanding Blood Types

   The presence or absence of specific antigens determines a blood type or group.4 Antigens can trigger an immune response if they are foreign to the body; thus, blood type matching is necessary to ensure safe blood transfusion and prevent the immune system from attacking the transfused blood.4

   4 min

3. 3

   Types of Blood Components for Transfusion

   Previously, whole blood transfusion was the only medical practice performed, but now it is rarely used.7 Blood component therapy is more commonly employed for blood transfusion as individuals only need specific blood components for their diseases and treatement.7 This allows multiple patients to ben

   4 min

4. 4

   Red Blood Cell Transfusion

   Red blood cells (RBCs) are prepared from the whole blood by removing the blood plasma (liquid portion).8 Red blood cells are used in cases of severe bleeding or to restore oxygen delivery to hypoxic tissues.10 Patients with acute bleeding resulting from an injury, trauma, chronic anemia, or gastroin

   4 min

5. 5

   Platelet Transfusion

   Platelets are commonly transfused in thrombocytopenic patients to treat and prevent hemorrhages.12 It is also beneficial for bleeding patients who have a normal platelet count, but still have platelet dysfunction from the use of antiplatelet drugs.11 Platelets are produced by centrifuging whole bloo

   4 min

6. 6

   Plasma Transfusion

   Blood plasma is involved in multiple bodily functions. It is the liquid portion of the blood that is used to carry RBCs, WBCs, and platelets around the body.8 Plasma is obtained from whole blood donations or component donations from apheresis.7 Plasma must be frozen 24 hours after donation and thawe

   4 min

7. 7

   Granulocyte Transfusion

   Granulocytes are white blood cells visible through microscopies, such as eosinophils, basophils, and neutrophils, due to prominent intracytoplasmic granules.14 It is important to note that granulocyte transfusion is not a common procedure and is only indicated in special cases.

   4 min

8. 8

   Crystalloid use During Blood Transfusion

   Fluid resuscitation is necessary in trauma cases with severe blood loss. Crystalloid solutions replace fluids and play a critical role in patient survival.16 A new concept, damage control resuscitation, was recently introduced that suggests that in cases of severely injured hypotensive trauma patien

   4 min

9. 9

   Pretransfusion Testing and Labs

   Pretransfusion testing and labs are important to ensure the right blood is given to the right patient at the right time.18 Many serological tests are involved when the blood is donated or dispensed from the laboratory to the patient’s bedside. This includes compatibility testing, donor selection, sc

   4 min

10. 10

    ABO and Rh Typing

    To check a patient’s ABO compatibility, both forward grouping (cell typing) and reverse typing (serum testing) are performed.18 This testing should be conducted on two samples collected at different times before finalizing the report. If any discrepancies are found, they should be resolved before mo

    4 min

11. 11

    Antibody Identification

    Antibody identification is conducted once antibody screening tests are positive.18 To specify an antibody, the sample is tested against multiple reagent red cells that express or lack a particular blood group antigen.18 The antibody specificity is determined based on the reactivity pattern against t

    4 min

12. 12

    Compatibility Testing

    For compatibility testing, different methods can be used, such as: 18

    4 min

13. 13

    Steps for Patient Verification Prior to Blood Transfusion

    Approximately 1 in 13,000 blood units are administered to the wrong patient, some of them leading to fatal outcomes.19 One of the major factors of this problem is patient misidentification or lack of communication among nurses. It is recommended that health care organizations have a process in place

    4 min

14. 14

    Signs of Transfusion Reaction

    Adverse reactions of blood transfusions are rare.1 For instance, common mild reactions that occur within 24 hours of transfusion include fever, itching, hives, and rash.1 In addition, there are adverse effects of blood transfusion that require immediate attention, including: 1

    4 min

15. 15

    Massive Transfusion Protocols

    Massive transfusion protocols (MTPs) are standard at trauma centers to help rapidly deliver blood to bleeding patients.22 The following are the current MTP standards for transfusion ratio: 22

    4 min

16. 16

    Religious Considerations for Blood Transfusion

    There are two religions that prohibit blood transfusions, Jehovah’s Witnesses and Christian Scientists. Jehovah’s Witnesses believe that it is against God’s will to accept blood transfusions, and they have no distinction between “taking blood into the mouth and taking it into the blood vessels."22 T

    4 min

17. 17

    Nursing Considerations

    The following guidelines can be useful for nurses and in the preparation of institutional standard operating procedures: 25

    4 min

18. 18

    Conclusion

    Blood transfusion has completely revolutionized healthcare and helped trauma and surgical patients.2 However, this simple procedure can lead to adverse effects if there is a lack of communication and poor identification measures in a healthcare organization. Thus, interprofessional team communicatio

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• Blood transfusion. Vic.gov.au. Published 2012. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/blood-transfusion
• Lotterman S, Sharma S. Blood Transfusion. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK499824/
• Treatments for Blood Disorders - Treatments for Blood Disorders | NHLBI, NIH. www.nhlbi.nih.gov. https://www.nhlbi.nih.gov/health/blood-bone-marrow-treatments
• American Red Cross. Blood Types. Redcrossblood.org. Published 2019. https://www.redcrossblood.org/donate-blood/blood-types.html
• NHS. Blood Groups. nhs.uk. Published October 17, 2017. https://www.nhs.uk/conditions/blood-groups/#:~:text=There%20are%204%20main%20blood
• Harmening D. Modern Blood Banking & Transfusion Practices. 7th ed. F.A. Davis Company; 2019.
• Target Information Systems Ltd. JPAC - Transfusion Guidelines. Transfusionguidelines.org. Published 2014. https://www.transfusionguidelines.org/transfusion-handbook/3-providing-safe-blood/3-3-blood-products
• Blood Components. www.redcrossblood.org. https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-donations/blood-components.html#:~:text=The%20transfusable%20components%20that%20can
• Mathew J, Varacallo M. Physiology, Blood Plasma. Nih.gov. Published January 20, 2019. https://www.ncbi.nlm.nih.gov/books/NBK531504/
• Franchini M, Marano G, Mengoli C, et al. Red blood cell transfusion policy: a critical literature review. Blood transfusion = Trasfusione del sangue. 2017;15(4):307-317. doi:https://doi.org/10.2450/2017.0059-17
• Blood Products - Hematology and Oncology. MSD Manual Professional Edition. https://www.msdmanuals.com/professional/hematology-and-oncology/transfusion-medicine/blood-products
• Solves Alcaina P. Platelet Transfusion: And Update on Challenges and Outcomes. Journal of Blood Medicine. 2020;Volume 11:19-26. doi:https://doi.org/10.2147/jbm.s234374
• FFP, Octaplas (fresh frozen plasma) dosing, indications, interactions, adverse effects, and more. reference.medscape.com. https://reference.medscape.com/drug/ffp-octaplas-fresh-frozen-plasma-999499
• Manjee K, Gniadek TJ. Educational Case: Granulocyte Transfusion. Academic Pathology. 2020;7:237428952090950. doi:https://doi.org/10.1177/2374289520909500
• Neutrophils (granulocytes) dosing, indications, interactions, adverse effects, and more. reference.medscape.com. https://reference.medscape.com/drug/neutrophils-granulocytes-999500
• Mane A. Fluid Resuscitation: Ringer Lactate versus Normal Saline-A Clinical Study. https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_1756_v1.pdf
• Rowell, S. E., Fair, K. A., Barbosa, R. R., Watters, J. M., Bulger, E. M., Holcomb, J. B., Cohen, M. J., Rahbar, M. H., Fox, E. E., & Schreiber, M. A. (2016). The impact of pre-hospital administration of lactated Ringer's solution versus normal saline in patients with traumatic brain injury. Journal of Neurotrauma, 33(11), 1054-1059. https://doi.org/10.1089/neu.2014.3478‌
• Basavarajegowda A, Shastry S. Pretransfusion Testing. PubMed. Published 2023. Accessed May 2, 2023. https://www.ncbi.nlm.nih.gov/books/NBK585033/#:~:text=ABO%20and%20Rh%20blood%20grouping
• JPAC. JPAC - Transfusion Guidelines. Transfusionguidelines.org. Published 2014. https://www.transfusionguidelines.org/transfusion-handbook/4-safe-transfusion-right-blood-right-patient-right-time-and-right-place
• Patient Safety Alert.; 2017. Accessed May 2, 2023. https://www.ehealthsask.ca/services/resources/Resources/PSA-2016-17-04-Correct-ID-Prior-to-Transfusion.pdf
• Ltd TIS. JPAC - Transfusion Guidelines. transfusionguidelines.org.uk. https://www.transfusionguidelines.org/transfusion-handbook/4-safe-transfusion-right-blood-right-patient-right-time-and-right-place/4-1-patient-identification
• Massive transfusion protocol in adult trauma population. The American Journal of Emergency Medicine. 2020;38(12):2661-2666. doi:https://doi.org/10.1016/j.ajem.2020.07.041
• ‌Gruberg M. Blood Transfusions and Medical Care against Religious Beliefs. www.mtsu.edu. Published 2009. https://www.mtsu.edu/first-amendment/article/908/blood-transfusions-and-medical-care-against-religious-beliefs
• Crowe EP, DeSimone RA. When blood transfusion is not an option owing to religious beliefs. Annals of Blood. 2022;7:22-22. doi:https://doi.org/10.21037/aob-21-58
• York N. New York State Council on Human Blood and Transfusion Services* and New York State Board for Nursing † GUIDELINES for MONITORING TRANSFUSION RECIPIENTS Fourth Edition 2012 *New York State Council on Human Blood and Transfusion Services. https://www.wadsworth.org/sites/default/files/WebDoc/857758683/monitorning%20txrecip0812final.pdf

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