Blood products Flashcards
Rhesus D
+ ve - presence of Rhesus D surface antigens on the red blood cells
- ve - absence of Rhesus D surface antigens on the red blood cells
Rhesus -ve if given RhD+ blood
Will make RhD antibody
Asymptomatic for pateint as do not have rhesus D antigens
But can affect pregnancy
Placenta
RhD antibodies can cross the placenta
Haemolytic disease of the newborn (HDN)
- Fetus blood crosses placenta
- First child - mother makes RhD antibodies
- 2nd RhD+ baby - anti RhD antibodies cross the placenta
- Attacks fetal RhD antigens
- Foetal anaemia
Universal donor
O-ve
No AB or rhesus antigens
Universal Acceptor
AB+ve
Group A
Anti B antibodies
Group and Save
Determines the patient’s blood group
Screens the blood for any atypical antibodies
Takes 40 mins
Crossmatch
Physically mixing the patient’s blood with the donor’s blood, in order to see if any immune reaction takes places
40 mins + 40mins for G+S
When is X match done
Blood loss is anticipated during surgery
Irradiated Blood Products
Reduce the risk of graft-versus-host-disease in at risk populations
Which groups should receive irradiated blood (6)
- Those receiving blood from first or second-degree family members
- Patients with Hodgkin’s Lymphoma
- Recent haematpoietic stem cell(HSC) transplants
- After Anti-Thymocyte Globulin (ATG) or Alemtuzumab therapy
- chemotherapy - purine analogues (e.g. fludarabine)
- Intra-uterine transfusions
Observations
- Before the transfusion starts
- 15-20 minutes after it has started
- At 1 hour
- At completion
Cannula
Blood products should only be administered through a green (18G) or grey (16G) cannula, otherwise the cells haemolyse due to sheering forces in the narrow tube
Packed Red Cells Indications
i) Acute blood loss
ii) Chronic anaemia, where the Hb ≤70g/L (or ≤100g/L in those with cardiovascular disease) or symptomatic anaemia
Duration over which Packed Red Cells is administered
2-4 hours
It must be completed within 4 hours of coming out of the store
Platelets Indication
(i) Haemorrhagic shock
(ii) Profound thrombocytopenia <20 x 109/L
(iii) Bleeding with thrombocytopenia
(iv) Pre-operative platelet level <50 x 109/L
Duration over which platelets is administered
30 minutes
Fresh Frozen Plasma (FFP) indications and constituents
Major constituents– Clotting factors
Indication:
(i) DIC
(ii) Any haemorrhage secondary to liver disease
(iii) All massive haemorrhages (commonly given after the 2nd unit of packed red cells)
Duration over which Fresh Frozen Plasma is administered
30 minutes
Cryoprecipitate constituents
Fibrinogen,
von Willebrands Factor (vWF)
Factor VIII
Fibronectin
Indications for cryoprecipitate
(i) DIC with fibrinogen <1g/L
(ii) von Willebrands Disease
(iii) Massive haemorrhage
Duration over which cryoprecipitate is administered
Stat
Massive haemorrhage blood products
Packed red blood cells
Fresh frozen plasma
Platelets
