Paediatric Nursing (PAED)
ADMINISTRATION OF BLOOD IN CHILDREN
This is the intravenous administration of blood or blood products to a child.
Purpose
- Restore blood volume
- Improve oxygen carrying capacity
- Replace clotting factors
- Correct anemia
Indications
- Severe anemia
- Blood loss
- Coagulopathy
- Thrombocytopenia
Equipment
- Prescribed blood product
- Blood administration set (pediatric)
- Normal saline 0.9%
- IV cannula and supplies
- Vital signs monitor
- Infusion pump
- Gloves
Preparation
- Verify order and consent
- Ensure patent IV access
- Obtain baseline vitals
- Have emergency equipment ready
Procedure steps
- Verify physician order
- Obtain informed consent
- Perform baseline vital signs
- Verify blood product with another nurse (two-person check)
- Check patient identity
- Prime tubing with normal saline
- Start transfusion slowly (first 15 minutes)
- Monitor closely for reactions
- Increase rate if no reaction after 15 minutes
- Complete transfusion within prescribed time
- Flush line with saline
- Monitor post-transfusion vital signs
Precautions
- Never add medications to blood
- Use blood warmer if indicated
- Complete within 4 hours
- Monitor for reactions continuously
Aftercare
- Monitor for delayed reactions
- Assess effectiveness
- Document response
- Dispose of blood bag properly
Nursing considerations
- Calculate appropriate volume
- Consider cardiac status
- Use infusion pump for accuracy
Patient education
- Explain purpose of transfusion
- Describe what to expect
- Report symptoms immediately
Documentation
- Blood product details (type, unit number, expiry)
- Pre/during/post vital signs
- Start and end times
- Any reactions
- Patient tolerance
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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