14. Blood Tranfsuions

Question 1

What are the different classes of blood that can be transfused?

Answer 1

Red cells- anaemia

Platelets- thrombocytopenia

fresh frozen plasma- low coagulation factors

cryoprecipitate- low fibrinogen

Question 2

Why would you transfuse something

Answer 2

Treat the patient, not the number on the bloods.

Heamoglobin could be normal but there could be now blood

Check blood pressure and pulse for best indications

Question 3

What does along with megaloblastic anaemia and can make blood transfusions difficult

Answer 3

cardiomyopathy

Question 4

What are the general rule for blood transfusion?

Answer 4

Keep heamoglobin above 70 unless there’s cardiac impairment, keep above 90/100

Question 5

Can blood group O receive group A platelets?

Answer 5

Yes, due to the platelets being suspended in platelets it has anti-B

Question 6

Can group O receive platelets safely?

Answer 6

Yes platelets are screened for high levels of anti A and anti B and so even though there will be heamolysis it won’t be too bad

Question 7

What number do you call if you need blood urgently

Answer 7

Call 2222 and say “major haemorrhage protocol activation” this get a porter who gets blood products rapidly. Stand the blood bank down, tell the, everything is sound

Question 8

What are the indications for platelet transfusion?

Answer 8

Prophylactically or therapeutically to stop bleeding
Diltuinal thrombocytopenia (massive transfusion)
Cardiopulmonary bypass surgery
DIC is youre bleeding/rare bleeding disorders

Question 9

What is FFP?

Answer 9

Fresh frozen plasma. Takes 20 minutes to thaw and 10 mins to deliver
Low A- teter can be given to any one no matter what blood group
If you’re born after 1996 yiu get imported solvent treated FFP as they haven’t been exposed to mad cow disease

Question 10

What are the indications for FFP?

Answer 10

Replacement of coagulation factors due to major haemorrhage
DIC in presence of bleeding
Thrombotic thrombocytopenia purpura
Replacement of coagulation factors when available

Question 11

Would you transfer ffp for factor VIII deficiency?

Answer 11

Nah not worth it without causing circulatory overload, better to use factor 8 concentrate

Question 12

Would you give FFP for someone with factor V deficiency would you give FFP

Answer 12

Yes there’s no concentrate factor 5

Question 13

Would you give FFP to someone bleeding in warfarin?

Answer 13

No give vitamin K and while that’s working give a multi coagulation factor

Question 14

Would you give FFP to someone taking a DOAC?

Answer 14

No take reversing therapy

Question 15

What is cryoprecipitate

Answer 15

Precipitate that forms by slow thawing of FFP. Has many clotting factors and most importantly fibrinogen

Question 16

When would you use cryoprecipitate

Answer 16

Hypofibrinogenawmia secondary to massive transfusion >1.5g/L

DIC associated with bleeding and fibrinogen

Bleeding associated with thrombolytic therapy cause if hypofibrinogaemia

Renal of liver failure and abnormal bleeding

Inherited hypofibroneganeamia if fibrinogen concentrate unavaible

Question 17

What are the principles for identifying someone’s blood type?

Answer 17

Group and screeen
Cross match
Two sample policy
72 hour (10 day) validity

Question 18

What is single unit issue?

Answer 18

The blood bank will issue one unit at a time?

Question 19

When do you give furesomide?

Answer 19

When you’re giving blood slowly, over 4-6 hours

Question 20

Discuss what should happen if pyrexia occurs after transfusion?

Answer 20

FNHTR- possible cause

• treatment antipyrexials, other symptoms usually more concern (shock/DIC)

Question 21

Ignore

Answer 21

Okay