Blood Transfusion: Indications, Hazards & Hemorrhage Control

✅ Control of Haemorrhage (Bleeding)

Controlling haemorrhage involves stopping the bleeding, maintaining circulation, and preventing shock. The approach depends on the type and severity of the bleeding.

Types of Haemorrhage

1. External Haemorrhage: Visible bleeding from a wound.
2. Internal Haemorrhage: Bleeding inside the body.
3. Arterial Bleeding: Bright red, spurting blood.
4. Venous Bleeding: Dark red, steady flow of blood.
5. Capillary Bleeding: Oozing blood from capillaries.

Methods for Controlling Haemorrhage

Immediate Measures (First Aid)

• Direct Pressure: Apply firm pressure directly on the wound with a clean cloth or dressing.
• Elevation: Elevate the bleeding part above the heart level, if no fracture is suspected.
• Immobilization: Keep the injured part still to prevent further injury.
• Pressure Points: Compress a major artery against a bone at a site above the bleeding.
• Tourniquet: Use as a last resort for life-threatening limb bleeding.

Medical and Surgical Management

• Hemostatic Agents: Medications like tranexamic acid or products like fibrin sealants that promote clotting.
• Suturing: Stitching or surgical ligation (tying off) of bleeding vessels.
• Electrocautery: Using heat to seal blood vessels.
• Embolization: A procedure in interventional radiology to block blood vessels.
• Replacement Therapy: For coagulopathies (clotting disorders) such as hemophilia.
• Fluid Resuscitation and Blood Transfusion: Administered in cases of significant blood loss to restore volume and oxygen-carrying capacity.

💉 Blood Transfusion

📌 Indicators for Blood Transfusion

A blood transfusion is administered when there is significant blood loss, severe anemia, or clotting disorders. Common indicators include:

Hemorrhage or Trauma

• Acute blood loss greater than 30–40% of total blood volume.
• Hemodynamic instability (e.g., low blood pressure, high heart rate).

Severe Anemia

• Hemoglobin levels below 7 g/dL in stable patients.

Surgery

• Major surgery with expected high blood loss.
• Correcting pre-operative anemia.

Bone Marrow Suppression

• For example, due to chemotherapy or aplastic anemia.

Coagulation Disorders

• Platelet transfusion for thrombocytopenia (low platelet count).
• Fresh Frozen Plasma (FFP) or cryoprecipitate for clotting factor deficiencies.

⚠️ Hazards of Blood Transfusion (Complications)

Immediate (Acute) Reactions

• Hemolytic Reaction: A life-threatening reaction due to ABO incompatibility.
• Febrile Non-Hemolytic Reaction: Characterized by fever and chills.
• Allergic Reactions: Can range from a mild rash to severe anaphylaxis.
• Bacterial Contamination: Can cause sepsis if the blood product is contaminated.
• Transfusion-Related Acute Lung Injury (TRALI): A serious complication causing respiratory distress.

Delayed Reactions

• Delayed Hemolytic Reaction: A slower destruction of red blood cells.
• Iron Overload: Occurs with chronic transfusions, leading to organ damage.
• Graft-versus-Host Disease: A rare but often fatal complication in immunocompromised patients.
• Infections: Transmission of viruses like HIV or Hepatitis B/C, now rare due to modern screening methods.

✅ Summary of Key Points