A&E π¨ Flashcards
What are the broad classifications of blood product transfusion complications?
Immunological, infective, transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), other complications (e.g., hyperkalaemia, iron overload, clotting).
What is a non-haemolytic febrile reaction caused by?
Antibodies reacting with white cell fragments and cytokines that have leaked from blood cells during storage.
What are the features of a non-haemolytic febrile reaction?
- Fever
- Chills
How should a non-haemolytic febrile reaction be managed?
Slow or stop the transfusion, administer paracetamol, and monitor the patient.
What causes a minor allergic reaction during a blood transfusion?
Foreign plasma proteins.
What are the symptoms of a minor allergic reaction?
Pruritus, urticaria.
What is the management for a minor allergic reaction?
Temporarily stop the transfusion, administer antihistamine, and monitor.
What can cause anaphylaxis during blood transfusion?
IgA deficiency in patients with anti-IgA antibodies.
What are the symptoms of anaphylaxis during a blood transfusion?
- Hypotension
- Dyspnoea
- Wheezing
- Angioedema
How should anaphylaxis during a transfusion be managed?
Stop the transfusion, administer IM adrenaline, provide ABC support, oxygen, and fluids.
What is an acute haemolytic reaction caused by?
ABO-incompatible blood due to human error.
What are the symptoms of an acute haemolytic reaction?
- Fever
- Abdominal pain
- Hypotension
What is the management for an acute haemolytic reaction?
Stop transfusion, confirm diagnosis, check patient identity, send blood for direct Coombs test, supportive care.
What causes transfusion-associated circulatory overload (TACO)?
Excessive rate of transfusion, pre-existing heart failure.
What are the symptoms of TACO?
- Pulmonary oedema
- Hypertension
How should TACO be managed?
Slow or stop transfusion, consider IV loop diuretic (e.g., furosemide) and oxygen.
What characterizes transfusion-related acute lung injury (TRALI)?
Non-cardiogenic pulmonary oedema due to increased vascular permeability.
What are the features of TRALI?
- Hypoxia
- Pulmonary infiltrates on chest x-ray
- Fever
- Hypotension
What is the management for TRALI?
Stop the transfusion and provide oxygen and supportive care.
What pathogens are RBCs primarily at risk for transmitting?
- HIV
- HBV
- HCV
What is the clinical impact of viral infections from RBC transfusions?
Chronic disease states such as chronic hepatitis or AIDS.
What is the risk associated with platelet transfusions?
Bacterial contamination due to storage at room temperature.
What are common bacterial contaminants of platelet transfusions?
- Staphylococcus epidermidis
- Bacillus cereus
What is the risk of infectious complications from blood products based on?
Storage conditions, components involved, and duration of storage.