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Oncology, haematology and palliative care > Blood products > Flashcards

Blood products Flashcards

1
Q

What must be measured every 30mins when giving blood?

A

TPR

BP

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2
Q

What is the haematocrit of the red cells blood product?

A

70%

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3
Q

When are red cells used?

A

To correct anaemia or blood loss

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4
Q

How much does 1U of red cells raise the Hb by?

A

10-15g/L

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5
Q

Till what Hb should you transfuse red cells to in anaemia?

A

80g/l

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6
Q

When are platelets given?

A

When bleeding or thrombocytopenic (<20X10^9/L)

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7
Q

What should 1U platelets raise the Hb by?

A

> 20 X10^9/L

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8
Q

What is fresh frozen plasma used for?

A

To correct clotting abnormalities - DIC, warfarin overdose (vit K too slow), liver disease, thrombotic thrombocytopenic purpura)

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9
Q

What percentage concentrations of protein is human albumin solution produced at?

A

4.5%

20%

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10
Q

When can 20% human albumin solution be used?

A

In the hypoproteinaemic patient - liver disease and nephrosis who is fluid overloaded without giving excessive salt load
Replacement in abdominal paracentesis

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11
Q

What is cryoprecipitate?

A

Source of fibrinogen

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12
Q

When are coagulation concentrates used?

A

Self injected in haemophilia

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13
Q

List some early complications of transfusion

A 
Acute haemolytic reaction
Anaphylaxis 
Bacterial contamination
Febrile reaction
Allergic reaction 
Fluid overload
Transfusion related acute lung injury (TRALI)
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14
Q

What is an acute haemolytic reaction caused by?

A

ABO or Rh incompatibility

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15
Q

Give the clinical features of acute haemolytic reaction

A 
Agitation 
Increased temp
Decreased BP
Flushing
Abdo/chest pain
Oozing venepuncture sites
DIC
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16
Q

How do you treat acute haemolytic reaction?

A 
Stop transfusion
Tell haematology 
Check name and identity on unit
Send unit and FBC, U&E, clotting, cultures, urine (haemoglobinuria) to lab
Keep IV line open with 0.9% saline
Treat DIC
17
Q

What are the clinical features of anaphylaxis to blood products?

A

Hypotension
Bronchospasm
Cyanosis
Soft tissue swelling

18
Q

How do you manage anaphylaxis

A

Stop transfusion
Maintain airway and give o2
Contact anaesthetist

19
Q

What are the clinical features of bacterial contamination from blood products

A

Increased temp
Decreased BP
Rigors

20
Q

How do you manage bacterial contamination from blood products?

A

Stop transfusion
Check name and identity of patient and compare to the unit
Tell haematology
Send unit & FBC, U&E, clotting, cultures and urine to lab
Start broad spectrum antibiotics

21
Q

Describe the features of transfusion related acute lung injury

A

Dyspnoea
Cough
CXR - white out

22
Q

How do you treat TRALI?

A

Stop transfusion
Give 100% O2
Treat as ARDS
Donor should be removed from the donor panel

23
Q

What are the symptoms of non-haemolytic febrile transfusion reaction

A

Shivering and fever usually 30mins-1hr after starting transfusion

24
Q

How do you treat non-haemolytic febrile transfusion reaction?

A

Slow or stop the transfusion
Give anti-pyretic (eg. paracetamol 1g)
Monitor closely
If recurrent, used WBC filter

25
Q

What symptoms does allergic reaction to blood products present as?

A

Urticaria and itch

26
Q

How do you treat allergic reaction to blood products?

A

Slow or stop the transfusion
chlorphenamine 10mg slow IM/IV
Monitor closely

27
Q

What are the features of fluid overload from a transfusion?

A

Dyspnoea, hypoxia, tachycardia, increased JVP and basal crepitations

28
Q

How do you treat fluid overload from a transfusion?

A

Slow/stop the transfusion
Give O2 and a diuretic eg. furosemide IV 40mg
Consider CVP line

29
Q

What is massive blood transfusion?

A

Defined as replacement of an individuals entire blood volume >10U within 24hr

30
Q

What are the complications of a massive blood transfusion?

A 
Hyperkalaemia
Hypothermia
Hypocalcaemia
Decreased platelets
Decreased clotting factors
31
Q

What blood should be used in acute haemorrhage?

A

universal donor group O Rh -ve until cross matched blood is available

32
Q

When should blood product be given to those with HF?

A

When Hb <50g/L

33
Q

What blood product should be given to those with HF

A

Packed red cells

34
Q

Describe how red cells should be given to someone with HF

A

Give 1 unit slowly over 4 hrs with 40mg slow IV/PO furosemide with alternate units

35
Q

What must you check for when giving red cells to those with HF

A

Increased JVP

Basal crackles

36
Q

Describe autologous transfusion

A

Where the patient receives their own blood

EPO given to harvest high yield of blood pre-op or intraoperative cell salvage and retransfusion

37
Q

What post-transfusion complication does low IgA increase the risk of?

A

Anaphylaxis

Oncology, haematology and palliative care (19 decks)

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