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RUSVM Anesthesiology > Blood Loss And Transfusion > Flashcards

Blood Loss And Transfusion Flashcards

1
Q

What are the blood products?

A 
Whole blood
Packed red blood cells 
Platelet rich plasma 
Fresh frozen plasma (cryoprecipitate) 
Oxyglobin
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2
Q

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

A

8hourse

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3
Q

What is in whole blood ?

A 
RBC
WBC
Platelets 
Plasma proteins 
Coagulation factors
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4
Q

Old whole blood lacks ??

A

Some unstable clotting factors

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5
Q

What are indications for whole blood transfusion?

A

Actively bleeding

Hypovolemia secondary to acute hemorrhage

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6
Q

What is in pRBC?

A

Packed red blood cells (PCV 70%)

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7
Q

When do you transfuse pRBCs?

A

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

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8
Q

When is platelet rich plasma indicated?

A

Severe bleeding in thrombocytopenic animals

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9
Q

Pure plasma contains?

A

Plasma proteins and all clotting factors except platelets

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10
Q

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

A

Clotting factor VII
Von willebrand factor
Fibrinogen

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11
Q

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

A

Oxyglobin (stabilized bovine hemoglobin based oxygen carrying solution)

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12
Q

What are adverse effects associated with oxyglobin?

A

Potential for circulatory overload ( colloid effect)

Allergic rxn (repeated dose)

Temporary discolouration of mucus membranes

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13
Q

What are the sources of blood products

A

From patient itself (auto-transfusion)

Donors (in hospital or from neighboring hospitals)

Animal blood banks

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14
Q

What are indications intra-operatively for blood transfusion

A

Severe acute hemorrhage

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15
Q

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

A

Severe acute hemorrhage usually from trauma

Hypoalbuminemia

Thrombocytopenia

Clotting factor deficiency

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16
Q

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

A

<20%

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17
Q

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

A

<15%

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18
Q

How can you estimate blood loss

A

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

19
Q

How much blood do you transfuse in acute hemorrhage?

A

Administer same amount as lost

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

20
Q

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

A

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

21
Q

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

A

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

22
Q

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

A

4 hrs

23
Q

What is the RBC survival time in dog?

A

110-120 days

24
Q

RBC survival time in cat?

A

75-80 days

25
Q

RBC survival time in horse and cattle

A

140-155 days

26
Q

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

A

False

27
Q

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

A

False

Dogs - no, lack alloantibodies

Cats- YES

28
Q

What is the most common blood type in dogs?

A

DEA 1.1

29
Q

What blood types in dogs are considered universal donors?

A

DEA 1.1 and 1.2 negative

30
Q

What are the blood groups present in cats?

A

A, B, and AB

Cats have naturally occurring alloantibodies - always type before first transfusion

31
Q

What are the most common blood groups in horses?

A

A, C and Q

32
Q

What are the most antigenic blood types in horses?

A

Aa and Qa

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

33
Q

What is major-cross matching?

A

Recipient plasma to donors RBC

If agglutination, positive cross match, do NOT transfuse

34
Q

What is minor cross matching?

A

Donor plasma vs recipient RBC

35
Q

What are clinical signs of a transfusion reaction?

A

Tachycardia and dysrhythmia

Hypotension

Tachypnea, dyspnea

Pyrexia

Wheals and urticaria

Vomiting

Seizure/tremors

CV collapse

36
Q

After a blood transfusion, you see…

Fever, uritcaria, angioedema, puritus, and tachypnea

What type of reaction is this and how would you treat it?

A

Allergic rxn

Stop transfusion
Diphenhydramine 
\+/- dexamethasone 
\+/- epinephrine (severe) 
Restart transfusion at slower rate
37
Q

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?

A

Analylatic shock

Stop transfusion
Symptomatic support (CPR?)
Epinephrine and dexamethasone

38
Q

After a blood transfusion, you see…

Tachypnea, fever, hemoglobinemia, hemoglobinuria, and shock

What type of reaction is this and how would you treat it?

A

Acute hemolysis

Stop transfusion
Dexamethasone
Saline diuretics
Maintain BP (dopamine?)

39
Q

After a blood transfusion, you see…

Slight increase in temp and bradycardia

What type of reaction is this and how would you treat it?

A

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

40
Q

After a blood transfusion, you see…

Tachypnea, pulmonary edema, and polyuria

What type of reaction is this and how would you treat it?

A

Circulatory overload

Stop transfusion 
Oxygen supplementation 
Furosemide 
Restart transfusion at a slower rate 
Consider different blood product
41
Q

After a blood transfusion, you see…

Low body temp

What type of reaction is this and how would you treat it?

A

Hypothermia

Stop transfusion and warm blood

42
Q

After a blood transfusion, you see…

Cardiac arrhythmias, tremors, and seizures

What type of reaction is this and how would you treat it?

A

Citrate overdoes induced hypocalcemia

Calcium salts and ECG monitoring

43
Q

After a blood transfusion, you see…

ECG abnormalities

What type of reaction is this and how would you treat it?

A

Hyperkalemia

Stop transfusion
Normal saline
Dextrose with regular insulin

RUSVM Anesthesiology (32 decks)

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