7.PRIOR TO THE FIRST DROP OF BLOOD GOING INTO PATIENT, TWO RN STAFF WILL CHECK , CHECK AND CHECK the patient name, order , bag of blood and type of blood and follow hospital policy, YOU WILL ALWAYS HAVE TWO RN CHECKING EACH UNIT OF BLOOD. This checking system will involve the following-a.An order for blood was writtenb.Type and crossmatch have been donec.The name of the patient and the name on the blood bag are identicald.The number assigned to the unit of blood is identical to the one on the requisition form for bloode.Blood type and RH factor are compatiblef.The blood has not exceeded its expiration dateg.The unit of blood is intact and has no bubbles or discoloration8.To id the patient by reading the arm band and asking the patient to tell you his or her name. check the arm band, against the name on the unit of blood 9.Gently invert the blood bag several times to mix the plasma and RBC’S10.Take and record a baseline of vital signs, this step I had earlier but the book says now. 11.Attach the open side of the Y tubing to the blood unit, and begin the transfusion at a slow rate of about 2ml per minute. (some trauma patients have to have blood infused at a rapid rate, some have special equipment to squeeze the bag so it will pump faster, this is normally seen only in trauma er situations not at bedside floor nursing level.), if this is needed the blood will have to be warmed prior to transfusion to prevent hypothermia. 12.Stay with patient for first and at least 15mins, monitoring for s/s of reaction and taking vital signs at hospital policy recommendations for vital signs, an example would be vs every 15mins for one hour then every 30mins for one hour then every hour for four hours, this would be done foreach unit of blood given. A single unit of blood can NOT hang for more than four hours. 13.After the first 15mins of transfusion, the rate may be increased if there is no danger of fluid volume overload, most patients can tolerate an infusion of a unit of blood (ranging from 250ml to 500ml, depending on the blood component) in 2 hours. 14.Book says 3-4 hours of blood hanging it begins to deteriorate, rodi and brittingham said in lab that it can NOT hang longer than four hours.