Instructions to Administer Platelets

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Platelets, also known as thrombocytes, are a type of white blood cell manufactured by bone marrow. They are crucial to the process of blood clotting and wound healing. Platelet disorders may be acquired or congenital. Acquired platelet defects include chronic mylogenous leukemia, multiple myeloma and kidney disease. Congenital platelet disorders include little-known diseases from birth such as Bernard-Soulier syndrome, Glanzmann's thrombasthenia and platelet storage pool disorder.

Things You'll Need

  • Venipuncture/indwelling IV access
  • Thermometer,
  • Blood pressure cuff,
  • Watch or a clock with second hand
  • Automatic vital sign monitor
  • Saline solution, 150 ml bag
  • Y-tubing
  • Blood-compatible IV pump
  • Double-check the doctor's orders for platelet administration and the number of units to be given. Double-check the patient's name against the chart and the patient's armband.

  • Explain "The Informed Consent to Medical or Surgical Procedure" form for the platelet transfusion to the patient and obtain his signature. File this document in the patient chart.

  • Call the doctor or resident to obtain a telephone or verbal order for a one hour post platelet transfusion platelet count, if this medical order has not already been written.

  • Administer antipyretics and/or antihistamines to the patient, if ordered, to prevent or lessen allergic reactions.

  • Obtain the requested units from the blood bank using your facility's release form.

  • Measure and record baseline vital signs - temperature, pulse, respiration and blood pressure.

  • Ask another licensed health care provider to confirm with you the label on the blood product bag against the patient armband. Obtain her co-signature on your facility's Blood Transfusion Record, documenting this extra measure of protection.

  • Connect the 150 ml bag of normal saline to one arm of the Y-set and prime the tubing. Close the clamp on the arm connected to the normal saline. Connect the bag of platelets to the remaining arm of the Y-set. If approved by your facility, a blood-compatible IV pump can be used to infuse the platelets at 100 ml per 15 minutes.

  • Monitor, measure and record baseline vital signs - temperature, pulse, respiration and blood pressure throughout the transfusion period.

  • Observe the patient for signs and symptoms of a transfusion reaction: bloody urine, chills, fainting, dizziness, fever, flank or back pain and a rash. Stop the transfusion and call the doctor immediately, if any of these symptoms occur.

  • Rinse the empty platelet bag with 5 to 10ml of normal saline by lowering the platelet bag and opening the clamp to normal saline. Re-hang the platelet bag at its original level and allow the remaining fluid to infuse.

  • Measure and record post-transfusion vital signs - temperature, pulse, respiration and blood pressure.

  • Document the completed transfusion on your facility's Blood Transfusion Record and in the patient's chart.

References

  • Photo Credit Jochen Sands/Digital Vision/Getty Images Jupiterimages/BananaStock/Getty Images Jupiterimages/Photos.com/Getty Images Thinkstock Images/Comstock/Getty Images
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