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CCHS SBB > Administration of Blood Components > Flashcards

Administration of Blood Components Flashcards

1
Q

who regulates collection of blood and blood components used for transfusion or for manufacture of pharmaceuticals derived from blood and blood components?

A

Center for Biologics Evaluation and Research (CBER)

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2
Q

FDA focus in regard to administration of blood components

A

blood collection centers and blood safety

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3
Q

what solution can be added to blood component transfusion according to FDA regulations?

A

normal saline 0.9%

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4
Q

requirements for administration of blood components mandated by?

A

AABB Standards and CAP requirements

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5
Q

most likely reason for acute intravascular hemolytic transfusion reaction

A

clerical error leading to ABO error

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6
Q

CAP standard: Is there a documented system in operation to detect and correct significant clerical and analytical errors, and unusual laboratory results, in a timely manner?

A

TRM.30400

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7
Q

CAP standard: Does the facility have a documented program to ensure that the risk of pretransfusion sample misidentification and other causes of mis-transfusion are monitored and subjected to continual process improvement?

A

TRM.30550

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8
Q

what 2 orders are required before blood products are transfused?

A

one to lab to request preparation of product

one to transfusionist to administer product and how product should be administered

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9
Q

IV catheter size for transfusing cellular components

A

22-14 gauge

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10
Q

prophylactic meds may be given how soon before transfusion?

A

oral 30-60 minutes

IV 10 minutes

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11
Q

can blood products be administered through the same line as any medication?

A

no - different line or flushed with normal saline

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12
Q

what is given prophylactically to reduce febrile nonhemolytic transfusion reactions in patients with past reactions and for patients with elevated temps before transfusion?

A

antipyretics

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13
Q

what is given prophylactically to reduce mild allergic or urticarial reactions?

A

antihistamines

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14
Q

what is given prophylactically to reduce rigors in patients with past reactions?

A

corticosteroids

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15
Q

what is the only solution compatible with blood products?

A

normal saline

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16
Q

what should be the last solution to go through the line before a blood component?

A

normal saline

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17
Q

indications for blood warning

A

hypothermia concerns from infusing cold blood components

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18
Q

controlled temperature of FDA approved warming device

A

below 42C

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19
Q

AABB Standard that applies to blood warmers

A

3.8

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20
Q

temperature at which red cell component cannot be reissued

A

10C

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21
Q

can a spiked unit be returned to the blood bank?

A

NO - infused within 4 hours or discarded

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22
Q

CAP TRM.30000

A

is there documentation of ongoing evaluation by laboratory director or designee of all of the following?
-control results of routine procedures, reactivity of reagents, instrument function checks, temperature records

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23
Q

CAP TRM.45009

A

are all storage units monitored 24 hours/day and equipped with an alarm (either remote or in the laboratory) that is tested periodically for its ability to alert responsible staff at all times?

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24
Q

CAP TRM.30800

A

is there a means to document the disposition of all blood components, derivatives, and tissues obtained, including the method of destruction or transfer of units unsuitable for transfusion or transplant?

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25
Q

when should inspection of blood components occur?

A 
before shipping from donor center to transfusion service
upon receipt in the transfusion service
at time of allocating to patient
at time of sign-out
at bedside before transfusion
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26
Q

component inspection for red blood cells

A

hemolysis in bag and segments

particulate matter and clots

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27
Q

component inspection for platelets

A

swirling

clots

28
Q

component inspection for plasma and cryo

A

fibrin strands

29
Q

standard blood filter

A

170 to 260 microns

30
Q

microaggregate filter

A

20-40 microns

31
Q

contraindication for microaggregate filter

A

platelets and granulocytes

32
Q

contraindication for leukocyte reduction filter

A

granulocyte components

33
Q

purpose of standard blood filter

A

remove small blood clots and particles potentially harmful to recipient

34
Q

function of microaggregate filter

A

removes smaller clots and particles including platelets and granulocytes; originally designed to remove leukocytes

35
Q

current typical use for microaggregate filter

A

shed autologous blood collected during surgery or during massive transfusion

36
Q

function of leukocyte reduction filter

A

reduces number of leukocytes in red cells and platelets to less than 5x10^6 cells per unit

37
Q

is pre-storage or bedside filtration preferred in leukocyte reduction?

A

pre-storage

38
Q

review during final issue of blood to prevent transfusion mishap

A 
2 recipient identifiers
recipient Abo/Rh
donor unique unit number
compatibility testing results
donor Abo/Rh
special transfusion requirements
expiration date and time
39
Q

documentation at issue of blood components

A

visual inspection
time and date of issue
technologist who issued component
name of person picking up component

40
Q

RBC infusion rate

A

150-300 ml/hr

41
Q

plasma infusion rate

A

200-300 ml/hr

42
Q

platelet transfusion rate

A

200-300 ml/hr

43
Q

cryo transfusion rate

A

as rapidly as tolerated by patient

44
Q

granulocyte transfusion rate

A

75-100 ml/hr

45
Q

assessment of recipient includes:

A

baseline physical assessment (vitals, temp, pulse, BP)

assessment for signs and symptoms before transfusion

46
Q

infusion rate of any blood product for first 15 minutes

A

2 ml/min

47
Q

when are vital signs taken during transfusion?

A

before and after

48
Q

OR and trauma infusion rate

A

as fast as 600-1500 ml/min

49
Q

what may be noted with rapid transfusions?

A

hypothermia, hypocalcemia

50
Q

patient unit tag/label must indicate:

A

2 recipient identifiers
donor unique unit number
compatibility testing result
attached securely to unit

51
Q

final records check of blood components must include:

A 
2 recipient identifiers
recipient ABO/Rh
donor unique number
compatibility testing results
donor ABO/RH
date and time of issue
special transfusion requirements
expiration date and time
52
Q

what must be in 100% agreement prior to issue of blood components?

A

identifying information
initial request
recipient’s records
all blood components

53
Q

actions performed by transfusion service technologist when issuing blood components in urgent situations

A

issue uncrossmatched blood, indicating on tag that crossmatch incomplete
start compatibility testing as soon as sample is received
contact medical director if uncrossmatched units are found to be incompatible

54
Q

emergency release blood if recipient’s blood type is unknown

A

group O
Rh negative to females of childbearing age
males and females over age 50 may receive Rh positive

55
Q

definition of massive transfusion

A

8-10 RBCs to adult patient within 24 hours

56
Q

acute massive transfusion definition

A

4-5 RBC units to adult patient within 1 hour

57
Q

massive transfusion to infant definition

A

exchange transfusion

58
Q

stop serological crossmatching blood after adult patient has received ___ during massive transfusion

A

> 10 units of RBC within 24 hours

59
Q

switching from group O AS-1, AS-3, AS-5 RBC units to ABO identical units can be safely done because?

A

minimal residual plasma in group O AS units

60
Q

minimal residual plasma is group O AS units lowers risk of…

A

passive anti-A and anti-B transmission

61
Q

what can be given if Rh-negative woman of childbearing age receives Rh-positive blood components to prevent anti-D from forming?

A

Rh IG prophylaxis

62
Q

requirements for return/reissue of blood components

A

primary container not tampered/entered
appropriate temp maintained at all times
one or more retention segments intact
written documentation states blood component passed inspection and is ready to be returned to inventory

63
Q

what happens to red cells if transfused with Ringer’s Lactate?

A

red cells clump due to ionized calcium chelating citrate

64
Q

medications containing calcium or gluconate solution do what if transfused with red cells?

A

neutralize CPD and cause blood to clot

65
Q

hypertonic solutions cause what to happen if transfused with red cells?

A

red cells lyse and break

66
Q

dextrose solutions cause what if transfused with red cells?

A

hemolyze, swell and clot

CCHS SBB (40 decks)

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