Blood Loss And Transfusion

Question 1

What are the blood products?

Answer 1

Whole blood
Packed red blood cells 
Platelet rich plasma 
Fresh frozen plasma (cryoprecipitate) 
Oxyglobin

Question 2

Whole blood can only be called fresh for how many hours after collection, then it becomes old whole blood

Answer 2

8hourse

Question 3

What is in whole blood ?

Answer 3

RBC
WBC
Platelets 
Plasma proteins 
Coagulation factors

Question 4

Old whole blood lacks ??

Answer 4

Some unstable clotting factors

Question 5

What are indications for whole blood transfusion?

Answer 5

Actively bleeding

Hypovolemia secondary to acute hemorrhage

Question 6

What is in pRBC?

Answer 6

Packed red blood cells (PCV 70%)

Question 7

When do you transfuse pRBCs?

Answer 7

Patients with allergic rxns to plasma proteins or with febrile non-hemolytic rxn to WBC

Question 8

When is platelet rich plasma indicated?

Answer 8

Severe bleeding in thrombocytopenic animals

Question 9

Pure plasma contains?

Answer 9

Plasma proteins and all clotting factors except platelets

Question 10

FFP that has been thawed several times is only rich in what clotting factors?

Answer 10

Clotting factor VII
Von willebrand factor
Fibrinogen

Question 11

What blood product is used to breast anemia in dogs and cats?

Answer 11

Oxyglobin (stabilized bovine hemoglobin based oxygen carrying solution)

Question 12

What are adverse effects associated with oxyglobin?

Answer 12

Potential for circulatory overload ( colloid effect)

Allergic rxn (repeated dose)

Temporary discolouration of mucus membranes

Question 13

What are the sources of blood products

Answer 13

From patient itself (auto-transfusion)

Donors (in hospital or from neighboring hospitals)

Animal blood banks

Question 14

What are indications intra-operatively for blood transfusion

Answer 14

Severe acute hemorrhage

Question 15

What are the indications for blood transfusion pre-operatively??

Answer 15

Severe acute hemorrhage usually from trauma

Hypoalbuminemia

Thrombocytopenia

Clotting factor deficiency

Question 16

Transfusion should be started is PCV is ________ causing an acute anemia

Answer 16

<20%

Question 17

Transfusion should be started is PCV is ________ in a chronic anemia

Answer 17

<15%

Question 18

How can you estimate blood loss

Answer 18

Amount in surgical site
Soaked swabs
Surface (table/floor spillage)

Question 19

How much blood do you transfuse in acute hemorrhage?

Answer 19

Administer same amount as lost

Always start slow at 0.25ml/kg for 30 mins then continue at 5-10ml.kg/hr

Question 20

How do you calculate how much blood to administer in a cat?

Answer 20

blood required (mL) = BW x 70(desired PCV-patient PCV / donor PCV )

Question 21

How do you calculate how much blood to administer during anemic hemorrhage to a dog?

Answer 21

blood required (mL) = BW x 90(desired PCV-patient PCV / donor PCV )

Question 22

You should aim to complete a blood transfusion within how much time?

Answer 22

4 hrs

Question 23

What is the RBC survival time in dog?

Answer 23

110-120 days

Question 24

RBC survival time in cat?

Answer 24

75-80 days

Question 25

RBC survival time in horse and cattle

Answer 25

140-155 days

Question 26

T/F: Blood products and fluid therapies can be administered through the same IV port

Answer 26

False

Question 27

T/F: cats and dogs required to be blood typed before their first transfusion

Answer 27

False Dogs - no, lack alloantibodies Cats- YES

Question 28

What is the most common blood type in dogs?

Answer 28

DEA 1.1

Question 29

What blood types in dogs are considered universal donors?

Answer 29

DEA 1.1 and 1.2 negative

Question 30

What are the blood groups present in cats?

Answer 30

A, B, and AB Cats have naturally occurring alloantibodies - always type before first transfusion

Question 31

What are the most common blood groups in horses?

Answer 31

A, C and Q

Question 32

What are the most antigenic blood types in horses?

Answer 32

Aa and Qa -pregnant mares carry the most antibodies, use geldings or nulliprous mares for donors

Question 33

What is major-cross matching?

Answer 33

Recipient plasma to donors RBC If agglutination, positive cross match, do NOT transfuse

Question 34

What is minor cross matching?

Answer 34

Donor plasma vs recipient RBC

Question 35

What are clinical signs of a transfusion reaction?

Answer 35

Tachycardia and dysrhythmia Hypotension Tachypnea, dyspnea Pyrexia Wheals and urticaria Vomiting Seizure/tremors CV collapse

Question 36

After a blood transfusion, you see... Fever, uritcaria, angioedema, puritus, and tachypnea What type of reaction is this and how would you treat it?

Answer 36

Allergic rxn ``` Stop transfusion Diphenhydramine +/- dexamethasone +/- epinephrine (severe) Restart transfusion at slower rate ```

Question 37

After a blood transfusion, you see... Sudden tachycardia, hypotension, cardiac arrest, and collapse What type of reaction is this and how would you treat it?

Answer 37

Analylatic shock Stop transfusion Symptomatic support (CPR?) Epinephrine and dexamethasone

Question 38

After a blood transfusion, you see... Tachypnea, fever, hemoglobinemia, hemoglobinuria, and shock What type of reaction is this and how would you treat it?

Answer 38

Acute hemolysis Stop transfusion Dexamethasone Saline diuretics Maintain BP (dopamine?)

Question 39

After a blood transfusion, you see... Slight increase in temp and bradycardia What type of reaction is this and how would you treat it?

Answer 39

Stop transfusion Dexamethasone and ketoprofen Restart at slower rate in 15mins

Question 40

After a blood transfusion, you see... Tachypnea, pulmonary edema, and polyuria What type of reaction is this and how would you treat it?

Answer 40

Circulatory overload ``` Stop transfusion Oxygen supplementation Furosemide Restart transfusion at a slower rate Consider different blood product ```

Question 41

After a blood transfusion, you see... Low body temp What type of reaction is this and how would you treat it?

Answer 41

Hypothermia Stop transfusion and warm blood

Question 42

After a blood transfusion, you see... Cardiac arrhythmias, tremors, and seizures What type of reaction is this and how would you treat it?

Answer 42

Citrate overdoes induced hypocalcemia Calcium salts and ECG monitoring

Question 43

After a blood transfusion, you see... ECG abnormalities What type of reaction is this and how would you treat it?

Answer 43

Hyperkalemia Stop transfusion Normal saline Dextrose with regular insulin