Blood Transfusions: Saving Lives in Hospitals
Blood transfusions play an important role in saving lives in hospitals. They are used by doctors to replace blood loss after surgery or after a catastrophic injury to a patient. Blood transfusions also help to improve the body's health and prevent further bleeding by providing patients with blood that is high in nutrients and coagulation factors. A small needle put into a patient's intravenous system aids in the delivery of healthy blood, and the process can take one to four hours depending on the volume of blood required. Blood transfusions are commonly given in three forms: red blood cells, platelets and clotting factor, and plasma. Each has its own benefits and risks. Analyzing the different types of blood transfusions to note their pros and cons to patients' health can grow nursing students' knowledge and help them make informed choices in their practice.
Red Blood Cell Transfusion
The purpose of red blood cells is to transport oxygen from the lungs to various body organs and tissues. In this regard, patients need red blood cell transfusions in cases of severe injury or anemia (Holst et al., 2015). Red blood cell transfusions help to restore the desired level of these cells in the blood to guarantee adequate oxygen supply in the body. Application of this procedure to trauma patients has shown an immense ability to amplify their survival rates (Holcomb et al., 2014). Therefore, nursing students should have a proper understanding of the technique to deal with accident and anemia cases in health facilities.
Nonetheless, they need to recognize its drawbacks. Contingent upon the strategy used to transfuse blood into a patient, the risk of infection exists. Holst et al. (2015) identify two types of red blood cell transfusions: the restrictive and the liberal transfusion. Restrictive blood transfusions occur when hemoglobin levels fall below seven grams per deciliter while the liberal transfusion happens when they go below 10 grams per deciliter. Research has shown that the risk of infections is higher in instances of liberal transfusion strategies. For this reason, nursing students should beware of possible problems in red blood cells transfusion.
Platelets and Clotting Factors Transfusions
Platelets and clotting factors impede bleeding after injury, including internal blood loss that is invisible. Using allogeneic products in health intervention measures has proved valuable in enhancing morbidity and mortality among patients. According to Clevenger & Mallett (2014), platelets and clotting factors transfusions have shown immense benefits in the treatment of liver diseases. Such illnesses alter primary hemostasis, fibrinolysis, and coagulation. The introduction of these elements into a person's body can help to reverse damage arising from liver diseases. Furthermore, their transfusion reduces mortality rates among patients undergoing complex surgeries.
Although transfusion of platelets and clotting agents has significant benefits for patients, it possesses some risks. One of the risks associated with this type of transfusion arises from the storage of the blood known as transfusion-related immunomodulation (TRIM). Stored blood can develop non-soluble mediators that affect the body's immunity. Thus, nurses should ensure the blood they intend to give patients was stored properly to guarantee its safety. In this way, they can lower the potential of infections during and after medical procedures, for instance, surgeries. Observing the recommended procedures of blood transfusions is especially important in pediatrics where the risk of hospital-related infections is significant (Muszynski, 2017).
Plasma Transfusions
Plasma refers to the liquid part of blood that contains the clotting factors, proteins, hormones, cholesterol, and other nutrients needed in the body. Such transfusions are common among patients who have acute liver diseases, bad burns, or severe infections. Due to the nature of the problems that this type of transfusion addresses, its benefits include saving the lives of critically ill patients and giving their bodies the nutrients they need to survive. Another major benefit of this type of transfusion is the low risk of infection connected to it due to the availability of pathogen-reduced plasma, which is approved by the Food and Drug Administration.
Plasma transfusions, however, have some drawbacks. Studies have shown that health professionals often overuse and inappropriately transfuse plasma (Shander, Ozawa & Hofmann, 2016). Two potential explanations for this problem are the underutilization of blood management techniques, particularly when treating bleeding problems, and a lack of transfusion guidelines. Nurses can contribute to the effective use of this blood transfusion method by acquainting themselves with what cases deserve a plasma transfusion and the proper application of the method. Although evidence of its clinical efficacy still remains scarce, it retains a high overall ability to improve patient outcomes.
Conclusion
Blood transfusions have maintained significant effectiveness in medical practice since their discovery. Nonetheless, they bring some negative consequences to patients' health. Understanding the risks can enhance the potential of nurses to prevent and address problems when they occur. The strengths and weaknesses of blood transfusions identified in this paper provide a basis for such comprehension. Most of them are ranked according to the nature of the blood transfusion where they occur, but nurses should remember that they can happen within any type of blood transfusion, particularly the infections. Thus, nurses should strive to understand the effective application of blood transfusions and measures that they can take to eliminate their incidence.
References
Clevenger, B. & Mallett, V. S. (2014). Transfusion and coagulation management in liver transplantation. World Journal of Gastroenterology, 20 (20): 6146-6158.
Holcomb, J. B., Donathan, P. D., Cotton, B. A., Junco, D. J., Brown, G., Wenkstern, T., Podbielski, J. M., Camp, E. A., Hobbs, R., Bai, Y., Brito, M., Hartwell, E., Duke, J. D. & Wade, E. C. (2014). Prehospital transfusion of plasma and red blood cells in trauma patients. Prehospital Emergency Care, 19 (1): 1-9.
Holst, L. B., Petersen, W. M., Haase, N., Perner, A. & Wetterslev, J. (2015). Restrictive versus liberal transfusion strategy for blood cell transfusion: Systematic review of randomized trials with meta-analysis and trial sequential analysis. BMJ, 350. doi: https://doi.org/10.1136/bmj.h1354
Muszynski, J. A., Spinella, C. P., Cholette, J. M., Acker, P. J., Hall, W. M., Juffermans, N. P., Kelly, P. D., Blumberg, N., Nicol, K., Liedel, J., Doctor, A., Remy, E. K., Tucci, M., Lacroix, J. & Norris, J. P. (2017). Transfusion-related immunomodulation: Review of the literature and implications for pediatric critical illness. Transfusion, 57 (1): 195-206.
Shander, A., Ozawa, S. & Hofmann, A. (2016). Activity-based costs of plasma transfusions in medical and surgical inpatients at a US hospital. Vox Sanguinis, 111 (1): 55-61.
