blood administration Flashcards
blood components
RBC, plasma, platelets, cryoprecipitate
cryoprecipitate
comes from plasma after freeze-thaw cycle
- mainly fibrinogen
- given to people with low fibrinogen
FFP
can be stored for a year
- does not provide platelets
- typical volume is 200-250
Rh
identifies whether a persons blood type is negative or positive
Blood group O antigen and antibodies
- no antigens on red cells
- anti A and anti B antibodies in plasma
blood group A antigen and antibodies
- “A” antigens on red cells
- anti B antibodies in plasma
blood group B antigen and antibodies
- “B” antigens on red cells
- anti A antibodies in plasma
blood group AB antigen and antibodies
- A and B antigens on red cells
- no antibodies in plasma
O negative compatibility to RBC and plasma
- compatible to O negative RBC
- can have any plasma
- universal RBC donor
O positive compatibility to RBC and plasma
- compatible to O + and O - RBC
- can have any plasma
A negative compatibility to RBC and plasma
RBC: A- O-
Plasma: A, AB
A positive compatibility to RBC and plasma
RBC: A+,A-,O+,O-
plasma: A and AB
B negative compatibility to RBC and plasma
RBC: B-, O-
Plasma: B and AB
B positive compatibility to RBC and plasma
RBC: B+,B-,O+,O-
Plasma: B and AB
AB negative compatibility to RBC and plasma
RBC: AB-,A-,B-,O-
Plasma: only AB
AB positive compatibility to RBC and plasma
RBC: universal receiver of RBC
Plasma: only AB
PRBC indications for use
- chronic or symptomatic anemia (fatigue, SOB, reduced O2)
- Restoration of blood volume
- dont treat with hemoglobin unless 70
- typical bag volume is 250ml
PRBC effect on hemoglobin and hematocrit
raises hemoglobin 1g/dL
raises hematocrit 3%
indication for administration of plasma
procoagulant deficiencies; DIC; trauma
indication for administration of platelets
control bleeding in platelet deficiency; thrombocytopenia
gauge sizing
22-14 appropriate but 20-18 better for general population
priming solution for blood
only use normal saline
filter for blood admin
170 micron filter
administration time
within 4 hours
Platelet indications for use
control bleeding in deficiency (thrombocytopenia), count less than 50,000, surgery with count less than 100,000, non-bleeding patients with rapidly dropping platelets less than 15,000
platelet admin guidelines
*admin 1 unit over 5-10 min
- 1 unit will raise platelets from 5 to 10,000
- usually admin 6-8 units at once
indications for plasma admin
procoagulant deficiencies, DIC, trauma
vitals for blood admin
within 30 min before administration, after 15 min, then every 1 hour
post transfusion VS
right when blood is done then monitor PRN
obtaining blood
can only get one unit at a time
reaction time
occurs within first 5-15 min
body systems to assess before admin
lungs, kidneys, lab values
informed consent
no time frame for amount of time it lasts but need to re-obtain if condition has changed, patient knowledge has changed, or there is a refusal to part of patient treatment
initial infusion rate
start transfusion at 50ml/h for first 15 min
maximum transfusion time
4 hours
administration after blood is collected from lab
must administer 30 min after getting from lab
post transfusion
flush line, take vitals, bag and tube must go in biohazard
equipment change
every 8 hours
cutaneous transfusion reaction S&S
key sign is urticaria, pruritus, erythema, jaundice, pallor, cyanosis
inflammatory transfusion reaction S&S
fever, chills, rigor
cardiovascular transfusion reaction S&S
tachy/bradycardia, hypo/hypertension, JVD
respiratory transfusion reaction S&S
dyspnea, wheezing, pulmonary edema,
GI transfusion reaction S&S
nausea, vomiting, diarrhea
Acute hemolytic transfusion reaction is caused by…
wrong blood to wrong patient or DIC
S&S of acute hemolytic transfusion reaction
dyspnea, fever, chills, lumbar pain, shock
treatment goal for acute hemolytic transfusion reaction
achieve and maintain adequate BP, give lasix, make sure urine output is 100ml/h
febrile transfusion reaction
can be caused by antibodies in blood
- people most at risk are those who have had blood transfusions in the past
S&S of febrile transfusion reaction
fever and chills
treatment for febrile transfusion reaction
stop blood, administer antipyretic
transfusion related acute lung injury timing
occurs hours within infusion
- provide O2 support
S&S of transfusion related acute lung injury related to blood flow, blood pressure and lungs
hypoxia, pulmonary edema, hypotension
Transfusion related circulatory overload
fluid is drawn to intravascular space if transfused too quickly
- dyspnea
- administer lasix
Cause of citrate toxicity
citrate in transfused blood binds calcium to patients body
citrate toxicity can cause…
hypomagnesia and hypocalcemia
transfusion associated graft vs host disease
fatal; lymphocytes attack recipient tissue
Delayed hemolytic transfusion reaction
may present as asymptomatic and can occur up to 4 weeks after infusion
- may have slight fever
