During surgery the patient has blood loss of 1500 mL. What impact will this have on the patient? How do you prepare for blood transfusion and what checks need to be carried out? Provide rationales for your answers

Question

What will be an ideal response?

Answer 1

Answer:
The fluid requirements of a patient undergoing surgery for liver resection where blood loss may be considerable can be difficult to estimate.
Patients may experience losses of up to 20 mL/kg/h.
The circulating nurse may be asked to provide the anaesthetist with an estimate of blood loss by weighing swabs and sponges and documenting irrigating fluid.
The anaesthetist will monitor the suction canisters for blood suctioned from the surgical site. They may also use invasive monitoring such as CVP.
The instrument nurse will be able to provide the amount of intraoperative irrigation fluid used.
Haemoglobin and arterial blood gas levels, together with haemodynamic values, may indicate the need for a blood transfusion.
Should a blood transfusion be indicated, the anaesthetic nurse should check the blood packs as per the Australian New Zealand Society of Blood Transfusions Standard. (Australian Commission on Safety and Quality in Health Care (ACSQHC) 2012).
To ensure patient safety and compatibility of the blood to be transfused, a number of checks must be undertaken by an RN and the anaesthetist. These checks include the patient's name, medical record number and date of birth, against the patient records and blood authority form. Other checks include blood group, the blood unit number, expiry date and the integrity of the package.
If any information is incorrect, it must be sent back to blood bank with documentation of same.
The anaesthetic nurse will prepare a blood-giving set that has a 170–200 micron filter.