Kim Bateman RN, BScN, CPHON®
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Analyze the unique considerations of the
pediatric patient

Determine strategies to address pediatric
needs
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Describe the family and nursing
education strategies to help meet the
specific patient population needs

Conditions requiring transfusions

Compensation

Dosages/Volume

Reactions

Family Education

Medical

Surgical

Hematological

Oncological
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Slow hemoglobin decline vs. rapid
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mL/kg

Neonates

Infants
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TRALI

Hyperleukocytosis
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Overload (TACO)
Overload/TACO:
Prevention
Recognition
Management
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Small volumes need extra consideration

Pain control and Maxilene!

Peripheral IV needle size
› As small as a 24 gauge needle
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Antibody development

Iron Overload

Liver impairment

Infectious complications

Great challenges with transition

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Enhanced need for
communication
Learning from oncology

Transition meetings
COG Long Term Follow-up Guidelines for
children that received blood:

More likely than adults to have a
reaction

Nurses must be prepared and educated

Algorithms

Reaction kits

Initial orientation for New staff:
› Case Study of a 5 year old patient with blood loss
and a DVT
› Full overview of Blood Administration process from:
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

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Type and Screen
Safe Dose
Cross match – identify the error
Administration
Concluding with reaction management
New Scenario after 6 months with a Sickle Cell
Patient – transfusion, fever, and pain control
Annual Updates:
 Case scenarios of patients receiving
platelets and red cells
 Review of safe checks and provincial
policy updates
Game of Guess Who
VZIG
Blood Doughnuts

All families in pediatric hematology/oncology
Basic versus complex family teaching
Basic information:
Complex information:
Child Life

Children are not the same as adults
› Care must be taken to ensure:
 The transfusion is necessary
 Ordered and administered correctly
 Monitored appropriately
 Education is provided

The more we work as an integrated
team, the safer the kids will be
Questions?
Rai, P et al (2016) “Unique aspects of red blood cell transfusion in pediatric patients.” International Journal
of Clinical Transfusion Medicine vol 4
Ambruso D., et al. (2013) “How do we teach pediatric topics in transfusion medicine: curriculum
development, learners, and instructional strategies.” Transfusion Vol 53
Lavoie J. (2011) “Blood transfusion risks and alternative strategies in pediatric patients.” Pediatric Anesthesia
vol 21
Strauss, R. (2009) “2008 Emily Cooley Memorial Lecture: lessons learned from pediatric transfusion medicine
clinical trials…a little child shall lead them.” Transfusion vol 49
Transfusion Policy and Procedures AHS
http://www.albertahealthservices.ca/lab/Page10380.aspx