Blood Content Flashcards by kurtis thompson

What is the appropriate storage condition for platelets?

20-24 c, with constant movement

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Which blood product is the preferred treatment for fibrinogen deficiency?

Cryoprecipitate

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Which patients require irradiated blood product?

Immunocompromised patients

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What is the recommended plasma transfusion dose for an adult patient?

10-15ml/kg

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What is the most common cause of bacterial contamination in platelet transfusions?

Skin flora from the donor

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Which transfusion reaction is potentially fatal and requires irradiation of blood components for prevention?

Transfusion associated Graft-versus host disease TAGvHD

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What is the estimated increase in heamoglobin after transfusing one unit of rbcs in an adult

10g/L

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What is the recommended platelet count threshoold before performing lumbar puncture in non-cirrhotic patients?

20 X109/L

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What is the main risk associated with transfusing O-negative blood to all emergency patients?

Depletion of emergency bloodsupply

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What is the preffered transfusion strategy for a patient with acute upper GI bleeding?

Restrictive transfuison at hgb 70-80 g/L

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Which test is NOT a standard blood bank test?

-ABO Typing
-Antibody screen
-Crossmatch
-WBC count

-wbc count

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What is the minimum hemoglobin level for transfusion in an actively bleeding patient?

70g/L

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How long should blood specimens forpre-tranfusion testing be valid?

72 hours

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Which transfusion reacton presents with hypotension and fever shortly after transfusion begins

Febrile non-hemolytic reaction. (Bacterial contamination)

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What is the purpose of giving Rh immunoglobulin to patients?

Preventing alloimmunization to the Rh(D) antigen

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What are the two postulated causes of TRALI

Donor leukocyte antibodies, reaction with neutrophils

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Which blood products must be ABO compatible?

Plasma and RBC’s must be compatible

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For major non-neuro-surgery, what is the recommended platelet transfusion threshold?

50X109/L

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When thawed, how log ca plasma be stored at 1-6C

5 days

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What is the correct storage temp for FP before thawing

-18 C or colder

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What is the minimum platelet count required for safe central venous catheter placment?

20 X 109/L

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What are the risk factors of TACO?

-70 years of age
-Heart failure
-Left vent. Dysfynction
-MI Hx
-renal dysfunction
-Positive fluid status

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How long should a single unit of RBC be infused over?

2 hours, to a max of 4hrs.

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Which procedure has a high-risk of bleeding and requires a platelet count of >50 X 109/L before surgery

Neurosurgery

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What is the most common symptom of acute hemolytic trannsfusion reaction

Fever and chills

What is the standard filter size for RBC transfusion administration

170-260 microns

How soon after a transfusion should a hemoglobin level be checked for response?

24 hours post transfusion

What is the purpose of Leukoreduction in blood products

To reduce febrile transfusion reactions

What is the main cause of DELAYED hemolytic reactions?

Pre-existing alloantibodies in the recipient

Which transfusion reaction is associated with donor leukocytes?

Febrile non-hemolytic transfusion reaction

What is the most effective way to prevent TACO?

Restrictive transfusion methods -Consider diuretics

How should blood components be identified before transfusion?

Verify name, DOB, unique identifier on wristband and blood label

What is the recommended threshold for prophylactic platelet transfusion in non-bleeding hypoproliferative thrombocytpenia

10 X 109/L

How long can red blood cells be stored at 1-6 C

42 days

What is the preffered IV fluid for RBCs transfusions

What is the recommended transfusion strategy for a hemodynamically stable child in pediatric critical care

Restrictive, 70g/L Hgb is the threshold to transfuse

What is the most common cause of acute hemolytic reactions

ABO-iincompatibility —sec to clerical error

What is the most common cause of acute hemolytic reactions

ABO-iincompatibility —sec to clerical error

What is he recommended ABO group testing for an infant less than 4 months old?

ABO and Rh(D) from either mother or infant

When can uncross-matched blood be given?

When patients comdition precludes waiting for an antibody screen and cross match

TRUE OR FALSE Thromobocytopenia is not a typical feautre of TACO

TRUE

What is the recommended dose of adult platelets?

1 pool

What is the maximum storage time for thawed plasma?

5 days at 1-6C

Is Thrombocytopenia a risk for TACO?

What is the recommended platelet count for patients undergoing neuro surgery

100 X 109/L

What is the most appropriate initial managment for TRALI?

Supportive care, mec vent if needed.

Which is not a typical feature of post-transfusion purpura (PTP) -Occurs 5-12 days post transfusion -more common in males -Platelet count often less than 10 x 109/L -Can occur after transfusion of RBCs, plasma or platelets

-more common in males. It is actually 5x more common in females.

What is the estimated risk of HIV transmission per unit of blood in canada

1 in 12,900,00

What are three common causes of non-immune hemolysis after transfusion ?

Overheating RBCs Hyoptonic IV solution Freezinof rbcs

What is the correct platelet count threshold for prophylactic platelet transfusion in patients with hypoproliferative thrombocytopenia?

10 X 109/L

What is the recommended INR for a plasma infusion prior to an invasive procedure?

1.8

What is the maximum storage time for irradiated red blood cells after irradiation?

14 DAYS

Which of the following is not common in an acute hemolytic transfusion reaction? -Fever -chills -hemoglobinuria -Thrombocytopenia

Thrombocytopenia

What is the cause of a febrile transfusion reaction?

Bacterial sepsis or contamination often cause by skin flora from donor, or bacteria from the donor that was unrecognized

Can you restart a transfusion after identifying a febrile transfusion reaction?

Yes, do so cautiously after consulting with EPOS. Provide supportive care.

Describe the clinical presentation of an acute hemolytic transfusion reaction.

S/S include fever, chills, hemoglobinuria, signs of shock/hypoperfusion.

You ID an acute hemolytic reaction with your patient receiving a blood transfusing. You immediately stop the transfusion. Are you able to resume the transfusion?

No, stop the transfusion and send remaining product to TMS for examination.

What is the cause of acute hemolytic reaction

ABO compatibility.

What are the two queried mechanisms that result in TRALI?

Anitbody mediated, neutrophil priming hypothesis

If TRALI is expected, should you restart the transfusion.

No, immediately stop the transfusion and contact TMS.

Out of all the transfusion reactions. Which can you resume a transfusion once stopped? TACO, TRALI, Febrile, hemolytic, delayed hemolytic, anaphylaxis, hypotension, GvHD

You may resume in the cases of… -TACO -Febrile reaction -Anaphylaxis

What are the two primary causes of TACO

Cardiovascular disfunction, transfusion rate.

Which medication are patients taking who commonly present with hypotension whilst recieving blood.

ACE inhibitors. Hypotension related to blood transfusion is often related to bradykinin. ACE breaks down bradykinin, taking an ace inhibitor may prevent the breakdown of bradykinin.

What are four common causes of hemolysis in blood transfusion

-use of hypotonic saline -overheating RBC’s -Freezing of RBC’s -Transfusion through a small needle

When can a delayed hemolytic reaction occur?

24hours-28days post transfusion.

What is the mortality percentage for TA-GvHD?

90% mortality rate.

List all transfusion reactions

-TACO -TRALI -FEBRILE REACTION -ACUTE HEMOLYTIC -DELAYED HEMOLYTIC REACTION -ANAPHYLAXIS -HYPOTENSION -TA-GvHD -PTP

What type of blood can A+ receive?

A+/- or O +/-

What type of blood can A- recieve?

A- or O-. They have Rh antibodies, not antigen on the RBC.

Which blood can a B+ type recieve?

B+/-, O+/-

What type of blood can AB- type receive?

AB-,O- A-, B-

What Can B- receive?

B-, or O-

What blood can AB+ Receive.

All types of

Who should receive O neg?

Females of child bearing age or potential

What is the universal plasma donor?

AB plasma.

If you are RH +, can you receive other compatible positive blood types

Yes because you already have the Rh antigen.

Which product is available for BCEHS paramedics?

O negative PRBcs AB Plasma

What is the main difference between adult and pediatric transfusion?

For pediatrics, initiate 20ml/KG Crystalloid first. Product dosing is 10ml/Kg

When should calcium be administered during blood transfusion?

1. CA+ <1.0mmol/L 2. After 4 units of product infused.