Blood products and transfusions Flashcards
4 main constituents of blood?
Erythrocytes
Leukocytes
Plasma proteins
Platelets
6 different types of plasma proteins found in the blood?
Ig Albumin - allows transport of bilirubin etc Hormones Vitamins Sugars, salts Clotting factors
If an immunocompromised patient is receiving blood transfusion what extra treatment is required for the blood?
CMV negative and irradiated blood therapy
Red cells are stored at what temperature? for how long?
4 degrees
35 days
What is fresh frozen plasma used for? stored at? for how long?
replaces all clotting factors - active bleeding very useful
frozen at -25 degrees
Can last 36 months
What temperature are platelet transfusions stored at and how long do they last?
22 degrees
5 days
What is cryoprecipitate, what temperature is it stored at, how long does it last?
Cryoprecipitate is fibrinogen
frozen at -25 degrees
Can last 36 months
Name 2 types of patients that coagulation factors would be administered to?
Haemophilia
Warfarin reversal
What is the transfusion threshold of Hb in patients under 65, over 65, with co-morbidities and with significant active bleeding?
Under 65 = below 70g/L
Over 65 = below 80 g/L
With comorbidities = below 90g/L
Significant active bleeding = below 100g/L
What is classified as significant active bleeding when considering transfusion thresholds?
over 500ml/hr
What factors need to be taken into account when considering a red cell transfusion?
Patient age - under or over 65
Any co-morbidities
Significant active bleeding
When labelling a blood sample what do you need to rememeber?
To fill the label out by hand
How many samples and at what time interval are needed for cross match samples of blood?
2 samples are needed for cross matching taken from the patient 5 minutes apart
What does the Maximum Surgical Blood Ordering Schedule do?
Offers guidance on the number of units of blood needed for specific operations
Determine if you need group and screen or group and crossmatch
How many hours do you have to transfuse patient after blood products have left storage?
4 hours
If someone experiencing massive amounts of bleeding what is activated?
Massive transfusion protocol
Ring lab and say you are activating Red Alert
Difference in requesting group and screen compared to group and crossmatch? What is performed for each one?
Group and screen = not expected to need blood, group, antibodies, held for 7 days
Group and cross match = expected to need blood, group, antibodies, check donor blood is compatible, held for 2 days
What is the name of the proteins on RBC that act as an antigen to the recipients antibodies during transfusion?
Agglutinogens
Which blood group is the universal donor?
O negative
Which blood group is the universal acceptor?
AB positive
How long does it take to fully cross match blood? to do a group-specific cross match?
40 minutes
15 minutes
What are the symptoms of an acute haemolytic reaction?
Fever, pyrexia, rash, pain at infusion site, bleeding (infusion site), DIC, RDS, hypotension, tachycardia, anxiety
What 4 methods can be used to avoid transfusions in the case of Jehovahs Witnesses for example?
Cell savage
tranexamic acid
Iron supplementation
Erythropoietin
What is SHOT?
serious hazards of infusion - monitors all reactions from transfusions and produces recommendations to improve safety
Name a few acute transfusion reactions that can happen?
Acute haemolytic anaemia Bacterial contamination Febrile non-haemolytic reaction Allergic transfusion related acute lung injury transfusion related circulatory overload
3 potential delayed transfusion reactions?
Delayed haemolytic reaction
Transfusion infections
Iron overload
What are some potential massive transfusion complications?
Hypothermia Hypocalcaemia Hyperkalaemia Coagulopathy Thrombocytopenia Acidosis
What is the test for haemolytic anaemia?
Coombs test
How many samples are needed for cross matching? when does the number of samples needed change?
2 samples 5 minutes apart
Do not need 2 samples when the patient has had a previous group and crossmatch
When are CMV negative components specifically asked for?
Immunocompromised
IU infusion to babies less than 20 weeks
Pregnant mothers
When do you need HLA matched red cells?
When the patient is waiting on a renal transplant or a transplant patient who doesnt take immunosuppressants
When are HLA matched platelets advised?
CKD
On transplant list not taking immunosuppressants
