Blood products/haemostasis Flashcards
components of packed red cells 5
red cells saline adeninine glucose mannitol citrate
voluem of prc and shelf life
230-340ml
35 day shelf life
at 4 degrees
how blood donation is processed
filter to remove leucocytes
process into red cells
pooled platelets
FFP
how blood donation is processed
filter to remove leucocytes
process into red cells
pooled platelets
FFP
tests run on donar blood 7
hiv hep b and c htlv syphylis abo and rhD other pehnotypes red cell antibodies CMV, HBS, Malaria
platelets storage temp and days
22 degrees
5 days
FFP storage temp and days
minus 25 and 36 months
what does FFP contain 5
clotting factors fibrinogen plasma proteins particuarly albumin electrolytes physiological anticoagulants - protein c, protein s, anti thrombin, tissue factor pathway inhibitor
when to use FFP -2
clinically singifcant bleeding without major haemorrhage if they have abnormal coag tests eg PT or APTT above 1.5
prophylactic for proceudres with abnormal coag with sig risk bleeding
reversal agents warfarin warfarin with bleeding heparin NOAC
vitamin K
beryplex, prothrombin complex concentrate
protamine , binds heparin, replenishes factor Xa
idarucizumab - praxbind for dagibatran, andexanet alpha
IDARUCIZUMAB · Drug action. Idarucizumab is a humanised monoclonal antibody fragment that binds specifically to dabigatran and its metabolites,
Praxbind
Andexanet alfa is a recombinant form of human factor Xa protein which binds specifically to apixaban or rivaroxaban, thereby reversing their anticoagulant
Andexxa
cryoprecipitate 5
fibrinogen vWF factor VIII factor XIII fibronectin
when to use cryo
consider if NO major haemorrhage and clinically significant bleeding and fibrinogen level below 1.5g/l
do not give if not bleeding and no procedure with risk of bleeding
massive transfusion protocol - baseline bloods 5
take baseline blood samples before transfusion for
massive transfusion protocol tranexamic how to manage team group o in females and males until lab results available what to give 4 if lab results available 4 situations
trauma and less than 3h from injury give tranexamic acid 1g bolus over 10 min followed by IV infusion 1g over 8 hours
state patient unique identifier and location
nominate person to liase with blood bank
group o neg in females and o pos in males
group specific blood when known
send porter to lab
until lab results available
giver further FFP 1L 4 units per 6 units red cells
consider cryo 2 pools
consider platelets 1 adult theraputic dose ATD
if lab results available falling Hb give red cells PT ratio >1.5 FFP 15-20ml/kg fibrinogen <1.5g/l - cryo 2 pools platelets less than 75 x 10 to 9 give platelets 1 ATD
continue cycle of clinical and lab monitoring and admin to goal directed therapy until bleeding stops
definition massive transfusion 3
transfusion 10 or more rbc which approximates to TBV of average patient within 24 hours
transfusion of more than 4 RBC with anticipated need continued blood
replacement of >50% of TBV by blood products within 3 hours
