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Blood Banking > Blood Banking 1 > Flashcards

Blood Banking 1 Flashcards

1
Q

Order

A
  1. Blood Donor Selection
  2. Blood Collection
  3. Unit processing and component preparation
  4. Compatibility testing
  5. Blood transfusion
  6. ***Transfusion reactions
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2
Q

Includes the medical history
, physical examination, and
serologic testing on the donor blood

A

Donor Screening

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3
Q

is very important in blood donation to
make sure the donor is well fit for donation, and to make sure the blood is safe and beneficial to the recipient of the blood

A

Medical history

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4
Q

Medical History Questionnaire

A

Consist of question answerable of “Yes” or “No”
 Answered on the same day as the donation

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5
Q

Physical Examination

A

Weight
Temperature
Pulse
Blood Pressure
Hemoglobin
Hematocrit
Age

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6
Q

Weight

A

110 lbs/ 50 kg (Standard)

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7
Q

Temperature

A

Donor temperature should be less
than or equal to 37.5C (99.5F)

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8
Q

Pulse

A

50-100 bpm

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9
Q

Blood Pressure

A

-Systolic: 90-160 mmHg (Systolic should not
exceed 180 mmHg)
-Diastolic: 60-100 mmHg (Diastolic should not exceed 100 mmHg)

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10
Q

Hemoglobin
Autologous?

A

greater than or equal to 12.5 g/dL (125 g/L)
> 11 g/dL

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11
Q

Hematocrit
Autologous?

A

greater than or equal to 38%
>33%

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12
Q

Age

A

18-65 years old

-17 years old can donate but should need a
parent’s consent

-Donors above 65 years old needs a physician’s consent

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13
Q

donors should be informed of the procedure for donating blood and its potential risks.

Donors must sign a statement documenting that they have given consent to the donation

A

Consent to donate

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14
Q

If the blood donor weighs less than 110 lbs

A

 Decrease the volume of blood collected
–Donor weight / Ideal weight X 450 mL = Volume of blood to draw (mL)

 Anticoagulant adjustment - Amount needed
–Volume of blood to draw / 100 X 14 = Volume of anticoagulant needed (mL)

 Anticoagulant adjustment - Anticoagulant
removed
–63 mL - AC needed = AC to remove (mL)

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15
Q

Can be done via CBC

A

Hemoglobin Testing

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16
Q

In hemoglobin Testing, if mass donation ____method can be used

A

CuSO4

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17
Q

CuSO4method

CuSO4 is placed in a _____
Up to ______ can be done in ______
Acceptable result:
Hemoglobin:

A

-30 mL container
-30 tests; one container
-The drop of blood sinks in the solution within 15 seconds.
->/= 12.5 g

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18
Q

-A donor who donates blood for his or her own use. (“Donor patient”).
-Most commonly used in patients with upcoming surgery

A

Autologous Donors

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19
Q

Autologous Donors Advantages

A

 Decreased risk of disease transmission
o Decreased risk to transfusion reactions
 Decreased risk to transfusion alloimmunization
 Blood for person with rare blood groups

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20
Q

Autologous Donors Disadvantages

A

 Bacterial contamination
 Circulatory overload
 Cytokine-mediated reactions
 Misidentification
 Higher cost

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21
Q

AAB stand for

A

American Association Blood Bank

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22
Q

Not feeling well

A
  • deferred temporarily
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23
Q

Drunk

A

deferred for 12 hours

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24
Q

Skin lesions at venipuncture site

A

deferred until fully recovered

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25
Q

Aspirin-containing medications

A

3-Days Deferral

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26
Q

2 Weeks Deferral

A

 Measles vaccine
 Mumps vaccine
 Polio vaccine
 Yellow fever vaccine
 Acute Febrile Illness (2-3 weeks/until fully recovered)

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27
Q

12 Months Deferral

A

 Syphilis
 Gonorrhea
 Animal bite
 Hepatitis vaccine
 Tattoo
 Skin penetration with sharp contaminated with blood Ear piercing
 Imprisoned
 Tooth extraction
 Household or sexual contact with individual w/ hepatitis, HIV
 Traveled to area endemic for malaria

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28
Q

3 Years Deferral

A

From an area (Citizen) endemic for malaria

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29
Q

Permanent Deferral

A

Parenteral drug use
Family history of Creutzfeldt Jakob disease
Treated with growth hormone
Viral hepatitis after 11thbirthday
Repeatedly reactive anti-HBc, anti-HCV, or anti-HIV
Babesiosis
Chaga’s disease
Cancer patient
Patients with bleeding disorders
Anemic

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30
Q

A numeric and Alphanumeric system is used to identify donor.
Carefully monitored to avoid
duplication or wrong identification.

A

Donor Blood Collection

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31
Q

The Phlebotomist must identify the donor and make sure the donor name and the identification number match.

A

Donor Blood Collection

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32
Q

 The donor states
 Donation should
 Donor bleeding:
 Donation Intervals:

A

his/her name
not exceed 10% of donor’s
7-10 minutes (Philippine standard = < 15 minutes
3-4 months

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33
Q

Blood Collection Sets

 Must be approved by the
 The set must be
 Key properties for containers
 Should be
 Should allow adequate

A

-Food and Drug Administration (or any governing body)
-sterile, uncolored, transparent, and hermetically sealed
-Flexibility, Pliability, Toughness
-kink and scratch resistant
- gas exchange of O2 and CO2 but prevent evaporation of the liquid

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34
Q

Blood Collection Sets

The whole blood collection set is a _____ with a ______ and one or more _____

Close system collection maintains

During component preparation, ______ is introduced into the system; instead an ______ or _______ allows the transfer of components from bag to bag

A

-closed system; primary bag; satellite containers
-sterility of the blood.
-no external air ;internal access port or cannula

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35
Q

Blood Collection Sets

The collection set may contain a ________integrally incorporated into the set to filter WBCs.

 If the seal is broken or compromised, the expiration date and time must be changed and the set is now considered as _______

A

-leukoreduction filter

  • “Open system.”
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36
Q

Collection Proper

  1. Inspect the blood bags for any
  2. Using a________, select a good site for venipuncture
  3. Follow aseptic technique

 Disinfect using

 Scrubbed the selected area at least

 Donors who are sensitive to iodine can use

  1. Insert the needle and position it properly.
    Tape the tubing to the donor’s arm to hold the needle in place
  2. Ask the donor to open and close the hand every 10-12 seconds during the collection proper
A

-defects, cuts, or discoloration
-tourniquet or blood pressure cuff

-Povidone-Iodine or Polymer iodine complex
-4 cm in all directions (minimum of 30 seconds)
-chlorhexidine gluconate or isopropyl alcohol

  • needle; tubing
    -open and close; 10-12 seconds
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37
Q

6._____the donor. Never leave the donor _____

  1. ___the blood bag every _____ to mix the blood and the anticoagulant
  2. After collection, ______ the needle and ____. ____ the segment of the blood bag.
  3. ______ the donor and let him/her remain seated for _____
  4. Give snacks to the donor _____
  5. Heat seal the tubing into _____. Cut ______for post collection testing (serological etc.).
A

-Monitor ; unattended
-Swirl; 45 seconds
-remove ; recap (fish-out method); Lock
-Reassure; 10-30 minutes.
-(water)
-segments; one segment

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38
Q

Fainting (anxiety or hypoglycemia)

A

 Stop the donation
 Administer glucose solution if necessary
 Position the donor that protects him/her from a possible fall

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39
Q

Convulsions (Anxiety or underlying disease)

A

 Stop the donation o Maintain airway
 Restrain gently to prevent injury
 Warn possible involuntary loss of control of urine and stool

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40
Q

Cardiopulmonary disease (underlying heart
disease)

A

 Stop the donation
 Apply ventilation, Cardiopulmonary resuscitation (if necessary)
 Donor is taken to the ER

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41
Q

due to fragile veins, unskilled
phlebotomist, uncooperative donor

A

Hematoma

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42
Q

Hematoma

A

 Stop donation if the hematoma is large
 Apply pressure to the site (5 minutes)
 Apply cold packs
 Reassure donor

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43
Q

inadvertent puncture of artery

A

Jet-like bleeding with bright red blood -

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44
Q

Jet-like bleeding with bright red blood

A

 Stop ASAP
 Apply dressing on site o Follow up donor for additional care

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45
Q

due to anxiety, hypoglycemia

A

Lightheadedness, Weakness, Tingling sensation, Palpitations

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46
Q

Lightheadedness, Weakness, Tingling sensation, Palpitations

A

 Reassuring conversations
 Elevate donor’s feet at 45 deg for few minutes then lower to 20 deg to increase venous return
 Apply cold, wet towels to the neck and
forehead
 Have the donor breath into a paper bag
 Provide juice even before donation
 Last resort: STOP DONATION

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47
Q

All units are processed before compatibility test and transfusion

A

Donor Unit Processing

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48
Q

Unit processing includes:

A

 ABO and Rh typing
 Antibody screening
 Serologic testing: Syphilis, Hepatitis B, Anti-HCV, Anti-HIV, Malaria
Component preparation
Unit storage: ASAP after processing at 1-6C.

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49
Q

confirm the ABO blood type of the donor blood

A

ABO

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50
Q

ABO
Must include:
Donor serum should also be collected for the:

A

forward and reverse typing
reverse typing

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51
Q

-Rh type should be tested with:
-In every negative typing, always test for:

A

-anti-D reagent
-weak-D

52
Q

A single blood unit can provide transfusion therapy to multiple patients in the form of RBCs, platelets, fresh frozen plasma, and cryoprecipitate.

A

BLOOD COMPONENTS PREPARATION

53
Q

Approved Preservatives

A

Sodium Citrate
Phosphate
Dextrose
Adenine

54
Q

 Binds Calcium in exchange for sodium salt

A

Sodium Citrate

55
Q

 supports metabolism of RBCs

A

Phosphate

56
Q

maintain RBC membrane o Substrate for ATP
production

A

Dextrose

57
Q

 provides energy for the RBCs
 Increases ADP levels

A

Adenine

58
Q

Provided by the manufacturer in the whole blood collection set and mixed with the donor blood during the collection process

A

Anticoagulants

59
Q

ACD stands for
CPD stands for
CPDA-1 stands for
CP2D stands for

and state its days

A

Acid-Citrate-Dextrose -21 days
Citrate-Phosphate-Dextrose-21 days
Citrate-Phosphate-Dextrose-Adenine - 35 days
Citrate-Phosphate-Double Dextrose - 21 days

60
Q

developed to further extend the
shelf-life of RBCs

A

Additive Solutions

61
Q

Additive Solutions contains:

and state its purpose

A

saline, adenine, and dextrose

  1. To suspend the solutes
  2. For increasing survival of RBCs
  3. To provide energy for RBCs
  4. RBC membrane stabilizing agent
62
Q

Blood component preparation

A

Fresh Whole Blood (450-500cc)

Platelet Rich Plasma (200-250cc)–PRBC (200-250cc)

Platelet Poor Plasma (200cc)–Platelet Concentrate (50-70cc)

FFP(200cc)

Cryosupernate (180-200cc)–Cryoprecipitate(15-20cc)

63
Q

Contains all cellular and liquid elements +anticoagulant and/or preservatives

A

Whole BLood

64
Q

Whole BLood

Intended to replace ______, _______on bleeding patients

-Volume:
-PCV:

Stored at

One unit can increase

Not used for __________replacements since it does not survive on stored whole blood.

A

-RBC (provide oxygen carrying capacity); Plasma (Volume expansion)
-450ml, 38%
-1-6C
-3-5% PCV, and1 -1.5g/dL Hemoglobin
-Platelet, WBCs, and clotting factor

65
Q

Prepared from Whole Blood via centrifugation or sedimentation after donation

A

Packed RBC

66
Q

Packed RBC

-Volume of RBCs =
- Plasma =
-Hematocrit =

Volume removed should be_____ of the total
plasma.

A

-200 ml
-100 ml
-70%

-80%

67
Q

Intended for patients that needs to increase its RBC mass and oxygen-carrying capacity without increasing the circulatory volume.

A

Packed RBC

68
Q

Decreased RBC mass may be caused by:

A

 Decreased production,
 Decreased RBC survival, Trauma or surgical
bleeding
 Critical levels that indicates transfusion is <6 g/dL
 Contraindicated in patients with well
compensated anemia

69
Q

Packed RBC

One unit can increase hemoglobin level to _____ and the hematocrit level to ____ in a typical ____ human (adjustment is quick compared to Whole blood)

A

1- 1.5 g/dL; 3-5%; 154 lbs

70
Q

Used for neonatal patients or infants under 4
months

A

RBC Aliquots

71
Q

 Neonatal transfusion may require only ____
 One aliquot can increase the hemoglobin of
infants at about ____ and hematocrit at _____

A

-10- 25mL
-2-3 g/dL, 6-9%

72
Q

RBC units with irradiated T-cells to prevent graft- versus-host disease

Intended for:

A

-Irradicated RBCs

-immunocompromised patients, bone
marrow transplant patients, fetus undergoing
intrauterine transfusion

73
Q

Recommended minimum dose of gamma
irradiation:

Done with?

A

25 Gy

Cesium-137 or Cobalt-60

74
Q

is used to confirm irradiation (darkening of the film)

Expiration date?

A

A radiochromic film label

28 days from the time of irradiation

75
Q

RBC unit with a WBC count reduced to <5 x 10° and with at least 85% of the original RBC mass. (original unit may contain about 2 x 10”)
– Reduced to 1 x 10

A

Leukoreduced RBCs

76
Q

RBC unit with a WBC count reduced to _____ and with at least ____ of the original RBC mass. (original unit may contain about _____)
 Reduced to ___

A

-<5 x 10°; 85%
- 2 x 10”
-1 x 10

77
Q

Donor WBCS can cause

A

-febrile non- hemolytic transfusion reactions
, transfusion- associated graft- versus-host disease
, transfusion-related immune suppression
, HLA alloimmunization
, and maynintroduce Cytomegalovirus

78
Q

Leukoreduced RBCs

Shelf-life:

A

24hours

79
Q

-Facilitates removal of 99.9% leukocytes via multiple layers of polyester or cellulose acetate non woven fibers
Retains 85%of the original RBC mass.

A

Prestorage Leukoreduction

80
Q

Prestorage Leukoreduction

Methods

A

In-line method
Plasma removal
Sterile docking device

81
Q

In-line filter attached to the whole blood unit and filtered via gravity

A

In-Line Method

82
Q

Plasma initially removed; remaining cells pass through an in-line filter.

A

Plasma Removal

83
Q

used to attach a leukocyte
reduction filter to a unit of RBCs, which is allowed to flow via gravity

A

Sterile Docking Device

84
Q

 WBCs are removed in the blood bank prior to issuing blood or at the bedside before transfusion.

 ______reduce leukocytes to____ or lower

A

Post-Storage leukoreduction

Third-generation filters; 5 X 10⁶

85
Q

Frozen RBCs that can be then stored up to ?

for patients with ?

A

-10 years
-rare phenotypes, for backup blood supply, and for autologous use

86
Q

Cryoprotective agents

A

Penetrating
Nonpenetrating

87
Q

involves small molecules that cross the cell
membrane into the cytoplasm o The osmotic force of the agent prevents water from migrating outward as extracellular ice is formed, preventing cellular dehydration

give its example

A

Cryoprotective agents Penetrating

Glycerol

88
Q

comprises large molecules that do not enter the cell but instead form a shell around it, preventing loss of water and subsequent dehydration

give its example

A

Cryoprotective agents Nonpenetrating

Hydroxyethyl starch (HES)

89
Q
  • common
     Increases the cryoprotective power of glycerol
     The freezer provides an initial temperature of -80C

RBCs are frozen within _____of collection (if
______ is used)
 Freezing temperatures: _____
 RBCs must be placed in the freezer within _____
 Also freeze a _____of the donor for additional testing in the future

A

High Glycerol (40% Weight per volume)

-6 days; CPD or CPDA-1 is used
- 65 C
-4hours of opening the system.
-serum

90
Q

Takes about 30 minutes o Units are placed in a 37 C water bath, and washed with solutions of decreasing osmolarity
 Expiration:
 Stored:

A

 Thawing process
-24 hours
-1-6C

91
Q

 Minimal glycerol cryoprotection
 Rapid and more controlled freezing procedure

It requires?
-Initial freezing temperature:
 Frozen units are stored at:

A

-Low Glycerol (20% Weight per Volume)

-Requires Liquid Nitrogen for the freezing process

-196 C
-120C

92
Q

Washed RBC

Intended for patients with?

For anemic patients with history of:

Shelf-life after washing:

RBC loss:

A

-rare IgA deficiency or anti-IgA antibodies.
-febrile reactions
-24 hours
-10-20%

93
Q

Eliminates plasma proteins to prevent allergic reactions.

A

Washed RBC

94
Q

Acquired from Whole Blood processing (random- donor)

A

Platelet Concentrate

95
Q

Platelet Concentrate

Platelets must be separated from the whole
blood within ____of collection

 Intended for
 May be contaminated with _______ so follow transfusion rules

A

-8 hours

-bleeding patients
(thrombocytopenic),
Cancer patients,
and thrombocytopenic preoperative patients

-RBCs or WBCs

96
Q

facilitates oxygen transfer into the
platelet bag and oxygen consumption of
platelets

A

Agitation

97
Q

 Random-donor platelet concentrates contains about__________platelets

 Stored in a _______ environment with agitation, and should contain adequate plasma of _____________

A
  • 5.5 x 10¹º platelets
    -20-24C ; 50-70mL, and a pH of 6
98
Q

Platelet Concentrate

 One unit should increase platelet count to ____________

 Transport at________: platelets
survive without agitation for a maximum of _____

 Shelf-life:
 If opened:

A

-5000- 10000/ul in a 70 Kg person
-Room temperature; 24 hours
- 5 days
-6 hours

99
Q

***Single-donor platelets
 Contains at least _______ platelets
 Stored at _________environment with agitation, and contains about ________
 Shelf-life: ____

A

-3 x 10¹¹ platelets
-2-24C environment; 300 ml plasma
-5 days

100
Q

Preparation

  1. Whole blood is
    centrifuge at _______
     Light spin _____
  2. Platelet Rich Plasma
     Centrifuge at ________
     Heavy spin __________
  3. Platelets_________
    - stand for _________
     Store at ___________
     Avoid _________
  4. Determine the _______ of the plasma bag and the______
A

-22C; 3200 RPM in 2-3 minutes

-22C; (3600 RPM in 5 minutes

  • 50-70 mL;1-2 hours at 20-24C with constant agitation
    -bacterial contamination

-weight and volume

101
Q

Note

6-8 units can be pooled in 1 bag (shelf-life is reduced to 4 hours)

A
102
Q

-Platelets can be leukoreduced to help prevent febrile non-hemolytic reactions

-Done via ________ designed for
platelets

A

-Leukoreduced Platelets

  • leukoreduction filter
103
Q

Note

Why do we need to reduced WBCs? Because remember that our platelet concentrate is around 50-70 ml, there is still plasma ,now the plasma may contain WBCs that can cause febrile reactions

A
104
Q

Despite the chemicals in the anticoagulant, the environment within the blood bag is different from the environment in the body. The impact of this altered environment on the blood product is referred as

A

“Storage Lesions.”

105
Q

EFFECTS OF STORED BLOOD (WHOLE BLOOD)

A

 Decrease pH
 Increase potassium
 Decrease 2, 3 DPG in RBCs
 Decrease glucose consumption
 Decrease ATP and Plasma sodium
 50% decrease of factor VIII in 24 hours
 50% decrease of factor V in 10-14 days
 Platelets and WBCs loss of function after few hours
 Building of lactic acid
 Increase in plasma hemoglobin

106
Q

POTENTIAL BENEFITS OF ARTIFICIAL OXYGEN CARRIERS

A

Abundant supply
Readily available for use in prehospital settings, battlefields, and remote locations
Can be stockpiled for emergencies and warfare
 No need for typing and crossmatching
 Available for immediate infusion
 Extended shelf-life
 Can be stored at room temperature
 Free of blood-borne pathogens
 At full oxygen capacity immediately
 Do not prime circulating neutrophils, reducing the incidence of multiorgan failure
 Can deliver oxygen to tissue that is inaccessible to RBCs
 Have been accepted by Jehovah’s witnesses
 Could eventually cost less than units of blood

106
Q

The following information is required on the label

A

 Proper name of the blood component (with included indication of any qualification or modification such as irradiation)
 Method of collection
 Expiration date (and time if applicable)
 Donor category
 Volume of the blood component
 The anticoagulant used in the preparation of the component
 Screening test results
 Storage temperature requirements of the blood component
 Special handling instructions

107
Q

is the liquid portion of whole blood

A

Plasma

108
Q

Can be prepared from whole blood via ____________

Contains all coagulation factors
-Used to treat
patients with __________________________

A

-centrifugation and sedimentation.

-liver failure, DIC, Vitamin K deficiency, warfarin overdose, singlef actor deficiencies, massive transfusion

109
Q

Plasma frozen shortly after separation from whole blood or within 8 hours of collection.

A

Fresh Frozen Plasma

110
Q

FFP

-preserved with ACD, it should be frozen within?
-Used for patients with ?
-Can be stored for up to?
-One unit contains?
-Thaw at ______if using a water bath, cover the unit to prevent water contamination.
-Thawed shelf-life:
-W/less factor V, Factor VII, Factor VIII, and Factor X compared to fresh plasma.

A

-6 hours
-active bleeding and multiple clotting factor deficiencies.
-1 year at -18°C or lower, or at -65°C for up to 7 years.
-150-250 mL of plasma
-30-37°C;
-24 hours; store at 1-6°C.
-Factor V, Factor VII, Factor VIII, and Factor X compared to fresh plasma.

111
Q

primarily used for fibrinogen replacement, Factor XIII deficiency, treating hemophilia A, and Von Willebrand disease

A

Cryoprecipitate

112
Q

Cryoprecipitate

-Prepared from?
-Cold-insoluble proteins precipitate out of plasma when thawed at _____ collected by centrifugation at ____
-______is removed via internal access port, retaining ______of plasma on the cryoprecipitate.

-Must be refrozen within _____ of removal from the cold environment and stored at ____or lower for up to 1 year.
-Thawed shelf-life:
- Contains??

A
  • Fresh Frozen Plasma.
    -4°C; 1-6°C.
    -Cryo-poor plasma (supernatant);5-15 ml

-1 hour; -18°C
-6 hours, or 4 hours (if pooled).
-Contains: Factor VIII, Factor XIII, Fibrinogen, Von Willebrand Factor, and Fibronectin

113
Q

-AABB requires at least :

A

-150 mg of fibrinogen per unit.

114
Q

T or F

Once thawed, store at room temperature and transfuse as soon as possible, as Factor VII levels decline 2 hours post-thawing

A

F; Factor VIII

115
Q

T or F

Fibrinogen replacement is crucial in patients with liver failure, DIC, and Congenital Fibrinogen deficiency.

A

T

116
Q

-is refrozen within 24 hours and
stored at -18C or colder for 1 year

-The product still contains?

A

-Cryo-poor plasma
-Albumin, Factor II, Factor
V, Factor VII, Factor IX, Factor X, Factor XI

117
Q

 From plasmapheresis of donors
 Acquired via fractionation and lyophilisation of pooled plasma

A

Factor VIII

118
Q

Intended for Factor VIII deficiency patients

A

Hemophilia A

119
Q

Other Plasma Derivatives

A

Factor IX concentrate (Prothrombin complex)
Immune Serum Globulin
Normal Serum Albumin

120
Q

Factor IX concentrate (Prothrombin complex)

Shelf-life:

Storage temperature:

Indication:

A

-varies on expiration date on the vial
- 1-6C
-Hemophilia B

121
Q

Immune Serum Globulin

Shelf-life:

Indications:

A
  • Intramuscular administration = 3 years, Intravenous administration = 1 year.

-Prophylactic treatment for patients exposed to hepatitis, measles, or chickenpox; treatment of congenital hypogammaglobulinemia.

122
Q

Normal Serum Albumin

Shelf-life:
Contents:
Indications:

A

-3 years at 20-24°C, 5 years at 1-6°C.
-96% Albumin, 4% Globulin.
-Used for plasma volume expansion in conditions such as surgery, trauma, and burns.

123
Q

REJUVINATION

-Regeneration of?
-RBCs should be?
- Incubate for _____ at _____ with ______

A

-ATP and 2, 3 DPG
- < 3 days after expiration
-1-4 hours at 37 C with Rejuvesol
(Phosphate, Inosine, Pyruvate, Adenine)

124
Q

only FDA approved rejuvenation
solution in US.

A

Rejuvesol

Blood Banking (1 decks)

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