Nurse Amanda is caring for a client with severe blood loss who is prescribed multiple transfusions of blood. Nurse Amanda obtains which most essential piece of equipment to prevent risk of cardiac dysrhythmias?

Correct Answer: B. Blood warmer

Rapid transfusion of cool blood puts the client at risk for cardiac dysrhythmias. Modern methods of very rapid transfusion in resuscitation would cause clinically dangerous hypothermia if unmodified, ice-cold blood were to be so transfused. These needs must be reconciled in the interest of adequate patient care–hence the need for blood warming. Countercurrent in-line blood warmers and the method of rapid warm saline admixture can both be used successfully for rapid, massive transfusions.

• Option A: Cardiac monitor is used to assess for any blood transfusion-related complication, but they do not prevent the occurrence of cardiac dysrhythmia. During the blood transfusion process, patients’ vital signs (heart rate, blood pressure, temperature, and respiration rate) should be monitored throughout the procedure and recorded. Follow the organization’s policy on how often the vital signs should be measured.
• Option C: ECG machine is used to assess for any blood transfusion-related complication, but they do not prevent the occurrence of cardiac dysrhythmia. Many severe reactions occur within the first 30 minutes of commencing a transfusion of a blood component unit (SHOT 2008). Close observation during this period is essential.
• Option D: Infusion pump is not beneficial in this case since the infusion must be given rapidly. SHOT 2008 recommends that patients be observed during the subsequent 24 hours because, on occasion, transfusion reactions can occur many hours after transfusion is completed.