Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 69 views

    Autotransfusion

    Uploaded by

    ydtrgn
    This document provides information on autotransfusion, which is the collection and reinfusion of a patient's own blood during or after surgery or trauma. It describes the prerequisites for autotransfusion including understanding transfusion therapy and indications for its use in trauma, cardiovascular or orthopedic cases. The document outlines the equipment needed, patient preparation including assessments for signs of hypovolemia, and contraindications to autotransfusion such as infection or coagulopathies. It also provides the procedure steps and references for additional information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Autotransfusion

    Uploaded by

    ydtrgn
    69 views5 pages
    This document provides information on autotransfusion, which is the collection and reinfusion of a patient's own blood during or after surgery or trauma. It describes the prerequisites for autotransfusion including understanding transfusion therapy and indications for its use in trauma, cardiovascular or orthopedic cases. The document outlines the equipment needed, patient preparation including assessments for signs of hypovolemia, and contraindications to autotransfusion such as infection or coagulopathies. It also provides the procedure steps and references for additional information.

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides information on autotransfusion, which is the collection and reinfusion of a patient's own blood during or after surgery or trauma. It describes the prerequisites for autotransfusion including understanding transfusion therapy and indications for its use in trauma, cardiovascular or orthopedic cases. The document outlines the equipment needed, patient preparation including assessments for signs of hypovolemia, and contraindications to autotransfusion such as infection or coagulopathies. It also provides the procedure steps and references for additional information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    69 views5 pages

    Autotransfusion

    Uploaded by

    ydtrgn
    This document provides information on autotransfusion, which is the collection and reinfusion of a patient's own blood during or after surgery or trauma. It describes the prerequisites for autotransfusion including understanding transfusion therapy and indications for its use in trauma, cardiovascular or orthopedic cases. The document outlines the equipment needed, patient preparation including assessments for signs of hypovolemia, and contraindications to autotransfusion such as infection or coagulopathies. It also provides the procedure steps and references for additional information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5

    P R OC E D UR E 1 9

    Autotransfusion
    Robin M. Beard

    PURPOSE:
    Autotransfusion is the collection and filtration of blood from an active bleeding site and reinfusion of that
    (autologous) blood into the same patient for the maintenance of blood volume.

    PREREQUISITE NURSING KNOWLEDGE


    • Understanding of transfusion and intravenous therapy and fluid balance is necessary.
    • Significant blood loss, related systemic hypoperfusion, and the associated decrease in oxygen-carrying capacity, with
    its impact on hypoxemia, often necessitate the replacement of blood with whole blood or packed cells. In appropriate
    patient populations (trauma, cardiovascular, or orthopedic surgical patients), autotransfusion should be considered as
    the need to replace blood becomes apparent.
    • Autotransfusion is commonly used for trauma victims and for patients undergoing cardiovascular and orthopedic
    procedures; it reduces the need for banked blood transfusions with the inherent risks of transfusion reactions and
    disease transmission.
    • A variety of autotransfusion devices are available. An autotransfusion system may be a standard water-seal chest
    drainage system (see Fig. 24-1, A), a separate autotransfusion setup, or a modified chest drainage autotransfusion
    system. In addition, continuous and intermittent systems are available. A continuous system has an intravenous line
    connected directly from the drainage unit collection chamber to the patient. An intermittent system uses a blood
    collection bag in-line between the chest tube and the collection chamber.
    • Many disposable systems available today have the ability to act as a reservoir for autotransfusion if the need arises. To
    initiate autotransfusion, the autotransfusion bag is disconnected from the disposable system and connected to the
    saline solution–filled blood administration tubing. Nurses should gain familiarity with their institution’s
    autotransfusion system and policies.
    • Indications for autotransfusion in the appropriate patient populations include active bleeding (greater than 100 mL/hr)
    and the accumulation of greater than 300 mL of drainage in the collection chamber.
    • Contraindications to autotransfusion include the following:
    Active infection or contamination of shed blood
    Malignant cells in shed blood
    Renal or hepatic insufficiency
    Established coagulopathies
    Blood that has been in the autotransfusion system for longer than institutional standards allow or as recommended
    by manufacturers
    • Any contraindications to autotransfusion are overruled in the presence of exsanguinating hemorrhage in the absence
    of an adequate supply of banked blood.
    • As with banked blood, patients may refuse to receive autologous blood based on religious beliefs.
    • Informed consent should be obtained in nonemergency situations.

    EQUIPMENT
    • Personal protective equipment
    • Autotransfusion collection system
    • Autotransfusion system replacement bag
    • Blood administration set
    • 40-µm microemboli filter
    • Normal saline (NS) intravenous (IV) solution

    PATIENT AND FAMILY EDUCATION


    • Explain the procedure to the patient, if appropriate, and the family, including the risks and benefits of using the
    patient’s own blood. Rationale: Information enhances patient and family understanding and decreases anxiety.

    PATIENT ASSESSMENT AND PREPARATION


    Patient Assessment
    • Signs and symptoms of hypovolemia and associated hypoperfusion include the following:
    Pale clammy skin
    Hypotension
    Tachycardia
    Dyspnea
    Decreased central venous pressure (CVP), pulmonary artery pressure (PAP), or pulmonary artery wedge pressure
    (PAWP)
    Decreased cardiac output or index
    Oliguria
    Decreased hemoglobin or hematocrit

    Patient Preparation
    • Verify correct patient using two identifiers. Rationale: Prior to performing a procedure the nurse should ensure the
    correct identification of the patient for the intended intervention.
    • Ensure that the patient understands preprocedural teachings. Answer questions as they arise, and reinforce
    information as needed. Rationale: This communication evaluates and reinforces understanding of previously
    taught information.
    Procedure for Autotransfusion
    References
    1. American Association of Blood Banks, Guidelines for blood recovery and reinfusion in surgery and trauma .
    American Association of Blood Banks, Bethesda, MD, 1997.
    2. American Association of Blood Banks. Technical manual, ed 16. Bethesda, MD: American Association of Blood
    Banks; 2008.
    3. Purcell, TB. Autotransfusion. In: Roberts JR, Hedges JR, eds. Clinical procedures in emergency medicine. ed 4.
    Philadelphia: Saunders; 2004:410–426.

    Additional Readings
    Americ an Assoc iation of Blood Banks Guidanc e for standards for perioperative autologous blood c ollec tion and administration. Americ an Assoc iation of Blood
    Banks, Bethesda, MD, 2002.
    Brown, M, Whalen, PK, Red blood c ell transfusion in c ritic ally ill patients. emerging risks and alternatives. Crit Care Nurse 2000; 1–14. [(S uppl)].
    Cross, MH, Autotransfusion in c ardiac surgery . Perfusion 2001; 16:391–400.
    Dial, S , Nguyen, D, Menzies, D, Autotransfusion of shed mediastinal blood. a risk fac tor for mediastinitis after c ardiac surgery? Results of a c luster investigation.
    Chest. 2003; 124(5):1847–1851.
    Ley, S J, Intraoperative and postoperative blood salvage . AACN Clin Issues 1996; 7:238–248.
    Oeltjen, AM, S antrac h PJ, Autologous transfusion tec hniques. J Intra ven Nurs . 1997; 20:305–310.
    S irvinskas, E, Veikutiene, A, Benetis, R, et al. Influenc e of early re-infusion of autologous shed mediastinal blood on c linic al outc ome after c ardiac surgery.
    Perfusion. 2007; 22(5):345–352.
    Weniger, J, von der Emde J, S c hric ker, K, et al. Autotransfusion of drainage blood after heart surgery. La ngenbecks Archiv Für Chirurgie. 1980; 351(4):229–241.
    [(author’s transl)].

    You might also like