AUTOGENIC TRANSFUSION
Jon McKenna
Md Sharif Mia
Anjanie Mohan
Learning Objectives
Define autogenic transfusion and explain its clinical significance in patient care.
Describe the process underlying autogenic transfusion and its effects on circulation
and oxygen delivery.
Identify clinical indications, benefits, and potential complications associated with
autogenic transfusion.
Apply evidence-based nursing standards and QSEN competencies to promote patient
safety during management of autogenic transfusion.
Demonstrate clinical reasoning to develop a patient-centered plan of care.
Autogenic Transfusion
A blood conservation technique in which a patient’s own
blood is collected and later returned to the same patient.
Blood is collected before a procedure (preoperative
donation), during surgery (through cell salvage), or after
a procedure (from surgical drains)
Once Collected blood is reinfused back into the same
patient
This process helps maintain circulating blood volume and
preserves the blood’s oxygen-carrying capacity
Autogenic Transfusion Process Overview
1
2
Blood is collected from the patient
either before surgery, during a
procedure, or from acute blood
loss using specialized collection
systems.
The collected blood is filtered
and processed to remove
debris, clots, and non-blood
materials
3
The salvaged red blood cells are
preserved and prepared for
reinfusion
The processed blood is then
reinfused back into the same
patient through intravenous
access
4
Continuous monitoring occurs
throughout the process to assess
patient response and detect
complications
The goal is to restore circulating
blood volume and improve oxygen
delivery while minimizing exposure
to donor blood
6
5
Technical Equiment used in Autogenic
Transfusion
Specialized suction
tubing and
collection
reservoirs designed
for blood salvage
2
Cell salvage
device
(autotransfusion
machine) used to
collect and
process the
patient’s blood
Sterile reinfusion
bags for returning
processed blood to
the patient
Filtration system to
remove debris,
clots, and
contaminants
3
1
5
4
Anticoagulant
solution to
prevent clotting in
collected blood
Vital sign
monitoring
equipment to
assess patient
response during
transfusion
7
6
Blood processing
chamber within
the device to
concentrate red
blood cells
9
8
Intravenous
tubing and IV
access for
reinfusion
Personal
protective
equipment (PPE)
for infection
control and safety
Clinical Indications and Benefits
Major surgeries with
01
anticipated significant
Eliminates risk of ABO
blood loss (orthopedic,
incompatibility reactions
cardiac, trauma surgery)
Trauma patients with acute
02
blood loss when blood
salvage is possible
Clinical
Indetifications
03
Patients with rare blood
types or difficulty finding
compatible donor blood
04
Patients who decline donor
blood for personal or
religious reasons
05
01
Situations where reducing
exposure to allogeneic
(donor) blood is preferred
Reduces risk of transmission
02
of infectious diseases
Decreases likelihood of
immune system reactions to
03
Benefits
donor blood
Preserves the patient’s own
red blood cells and clotting
04
factors
Supports patient-centered
care by honoring patient
05
preferences
It can significantly decrease the
need for donor blood products
and improve patient safety.
06
COMPLICATIONS OF AUTOGENIC
TRANSFUSION
Bacterial
contamination from
improper collection or
handling, which can
lead to fever, chills, or
signs of infection
Fluid overload related
to large-volume
reinfusion, potentially
causing shortness of
breath, crackles, or
increased blood
pressure
Air embolism if air
enters the reinfusion
system, a rare but
potentially lifethreatening
complication
Hemolysis caused by
mechanical damage to
red blood cells during
collection or reinfusion,
reducing the
effectiveness of the
transfusion
Clot formation if
anticoagulation or
equipment function is
inadequate,
increasing the risk of
embolic events
Electrolyte imbalances
such as changes in
potassium or calcium
levels, which may affect
cardiac and
neuromuscular
function
Incomplete recovery
of usable blood,
which may require
additional donor
transfusion to meet
the patient’s needs
Standard and Guidlines For Autogenic Transfusion
Informed consent is essential. The patient must understand the procedure and agree
to it before any blood is collected or reinfused.
Correct patient identification is critical at all times to prevent errors. This includes
verifying the patient’s name, date of birth, and matching labels accurately.
Aseptic technique must be strictly maintained to reduce the risk of infection.
Blood must also be properly labeled, handled, and stored according to protocol
Approved equipment and institutional protocols must be followed to ensure safety
and consistency of care.
Patient must be closely monitored for vital signs, tolerance, and any adverse
reactions. during reinfusion
All care and patient responses must be clearly documented in the medical record.
Practice is guided by AABB and facility policies to ensure safe, evidence-based care.
Patient Introduction
Mr. Collins is a 19-year-old male who presents to
the emergency department following a highspeed motor vehicle collision. He was the
restrained driver of a vehicle that sustained
significant front-end damage after being struck
on the driver’s side. Emergency Medical Services
report that the patient was alert at the scene but
complained of severe left leg pain, dizziness, and
increasing weakness during transport.
Upon arrival to the emergency department, Mr.
Collins appeared pale and diaphoretic and
reported feeling “lightheaded” and “about to pass
out.” The patient was stabilized in the emergency
department and subsequently taken to the
operating room for thoracic intervention.
Due to anticipated blood loss and the presence of
a hemothorax without evidence of
contamination, intraoperative cell salvage was
utilized to collect and reinfuse the patient’s own
blood, thereby reducing the need for donor blood
products.
Patient Information
Patient: Mr. Collins
Age: 19 years
Sex: Male
Demographics:
Sex: Male
No Known Drug Allergies
Vital Signs on Arrival:
Blood Pressure: 88/54 mmHg
Heart Rate: 128 beats/min
Respiratory Rate: 24 breaths/min
Oxygen Saturation: 95% on room air
Temperature: 36.4°C (97.5°F)
General Appearance:
Pale
Diaphoretic
Appears weak and anxious
Social History:
Denies tobacco or illicit drug use
Occasional alcohol use
Diagnostic Data
Imaging Studies:
X-ray of the left femur:
Comminuted mid-shaft femur fracture
CT scan of the chest:
Large left-sided hemothorax indicating
accumulation of blood within the thoracic
cavity
CT scan of abdomen and pelvis:
No solid organ injury identified
Laboratory Findings:
Hemoglobin: 7.8 g/dL (low)
Hematocrit: 23% (low)
Lactate: Elevated, consistent with
hypoperfusion
Type and Screen: Completed
Question
Can anyone think
of any Nursing
Diagnosis relating
to this patient?
Patient Problems
RISK OF
SHOCK
RELATED TO
INTERNAL
HEMORRHAGE
RISK OF
EXCESSIVE
BLEEDING
RELATED TO
FEMUR
FRACTURE
INEFFECTIVE
PERIPHERAL
TISSUE
PERFUSION
RELATING TO
REDUCED
CIRCULATING
BLOOD VOLUME
ACUTE PAIN
RELATED TO
TRAUMATIC
FEMUR FRACTURE
IMPAIRED
PHYSICAL
MOBILITY
RELATED TO
MUSCULOSKELE
TAL INJURY
Question
Which one of the
Mr. Connor’s
problems takes
priority?
SOAPIE Note
Subjective Data
S
Patient reports feeling “lightheaded,”
“weak,” and “about to pass out.”
Complains of severe left leg pain
following a high-speed motor vehicle
collision. Reports dizziness that worsened
during transport to the emergency
department.
Plan
P
Interventions
Objective Data
0
Blood pressure: 88/54 mmHg
Heart rate: 128 beats/min
Respiratory rate: 24 breaths/min
Oxygen saturation: 95% on room
air
Skin pale, cool, and diaphoretic
I
Assessment
A
Risk for Shock related to internal
hemorrhage secondary to traumatic
femur fracture and hemothorax, as
evidenced by hypotension, tachycardia,
low hemoglobin/hematocrit, pallor,
diaphoresis, and signs of decreased
tissue perfusion.
Restore and maintain adequate
circulating blood volume through
autologous transfusion
Monitored vital signs every 5–15
minutes during acute phase
Evaluation
E
improved hemodynamic stability, with
gradual improvement in blood
pressure and heart rate.
INTERVENTIONS
FOR PRIORITY
PROBLEM
Acute blood loss with decreased
circulating red blood cell volume related
to traumatic injury (femur fracture and
hemothorax), as evidenced by
hypotension, tachycardia, low
hemoglobin/hematocrit, and signs of
hypoperfusion.
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Restore and
Maintain systolic blood pressure > 90 mmHg and heart rate
< 100
Improve hemoglobin to
bpm
≥ 10 g/dL through transfusion therapy
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Maintain adequate tissue perfus
output 30 mL/hr)
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Prevent progression to hemorrhagic shock
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Reduce complica
Nursing Interventions
01
Monitor vital signs every 5–15
minutes during acute phase
05
Administer ordered blood
products and monitor for
transfusion reactions
02
Assess for worsening signs of
shock (cool skin, delayed cap
refill, ↓ LOC, ↓ urine output)
06
Provide oxygen therapy as
indicated to support oxygen
delivery
03
Monitor hemoglobin,
hematocrit, and lactate trends
07
mplement bleeding
precautions and minimize
unnecessary blood draws
04
Maintain large-bore IV access
for fluid and blood
administration
08
Educate patient on procedure,
purpose of transfusion, and
symptoms to report
A nursing intervention is a specific action a nurse performs to help a patient achieve
desired health outcomes and to address identified nursing diagnoses or problems.
QSEN EBP applied to Patient
Patient-Centered Care: Explained procedures to Mr. Collins to
reduce anxiety and promote understanding
Evidence-Based Practice: Used trauma transfusion guidelines
to guide timely blood replacement
Safety: Followed transfusion verification protocols to prevent
errors
Teamwork & Collaboration: Coordinated with ED, trauma
team, lab, and radiology
Quality Improvement: Evaluated patient response to
interventions and adjusted care
Informatics: Utilized electronic charting for accurate tracking
of vitals, labs, and interventions
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Rapid blood loss from femur fracture and hemot
INTERVENTIONS
&
DISCUSSION
POINTS
Early recognition of hypovolemia is critical for survival
Autogenic transfusion may reduce exposure to do
nor blood when clinically appropriate
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Nursing assessments play a
Trauma care requires continuous reassessment and interdisciplinary coordination
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Patient
Collaborative Management
Emergency Physician / Trauma Team: Directed resuscitation and transfusion plan
Nursing: Continuous monitoring, transfusion administration, and patient advocacy
Laboratory: Provided rapid CBC, lactate, and blood typing for transfusion readiness
Radiology: Confirmed injuries (hemothorax, femur fracture) through imaging
Respiratory Therapy: Assisted with oxygen delivery as needed
Patient: Communicated symptoms such as dizziness and weakness to guide care
Reflection
This case strengthened our understanding of how quickly trauma patients can
decompensate
We learned the importance of recognizing early signs of hypovolemia and shock
This reinforced the nurse’s critical role in monitoring during transfusion therapy
Applying QSEN competencies improved our understanding of safe, evidence-based care
This experience will help us feel more confident caring for unstable patients in clinical
practice
References
Andrianova, N. V., & Colleagues. (2025). Hemorrhagic shock and mitochondria: Pathophysiology and implications for
management. International Journal of Molecular Sciences, 26(5), 1843.
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Elsevier.
Bonanno, F. G. (2023). Management of hemorrhagic shock: A physiology approach. Journal of Clinical Medicine, 12(1), 260.
https://doi.org/10.3390/jcm12010260
Hinkle, J. L., & Cheever, K. H. (2022).
Brunner & Suddarth’s textbook of medical-surgical nursing (15th ed.). Wolters Kluwer.
Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2021).
Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed.). Elsevier.
Lewis, S. L., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2020).
Medical-surgical nursing: Assessment and management of clinical problems (11th ed.). Elsevier.
Pellegrino, P. R., & Colleagues. (2025). Sympathetic vasomotion as an early marker of hemorrhage. Frontiers in Physiology.
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2021). Fundamentals of nursing (10th ed.). Elsevier.
Sherwood, G., & Barnsteiner, J. (2021). Quality and safety in nursing: A competency approach to improving outcomes (3rd
ed.). Wiley-Blackwell.
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