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Emergency Medicine > Blood Products & IV Fluids > Flashcards

Blood Products & IV Fluids Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Role of Blood in Oxygen Delivery

A

Blood delivers oxygen to tissues
Anemia impairs oxygen delivery
Oxygen delivery = cardiac output x arterial oxygen content

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2
Q

Risks of Transfusing Blood Products

A 
Infection
Allergic and immune transfusion reaction
Volume overload
Hyperkalemia
Iron overload
Surgical patients
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3
Q

Patients who are More Sensitive to Volume Overload

A

Elderly
Children
CHF

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4
Q

Patients who are More Sensitive to Hyperkalemia

A

Newborns
Renal failure
Massive transfusions

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5
Q

Patients who Develop Iron Overload

A

Large number of transfusions

Chronic Anemia

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6
Q

Define Massive Transfusion

A

Replacement of blood volume in a 24 hour period OR 50%+ of blood volume in 4 hours

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7
Q

Pneumonic for the Complications of a Massive Transfusion

A

PATCH

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8
Q

What does the pneumonic PATCH stand for in massive transfusions?

A 
P: platelets decrease, potassium increases
A: ARDS, acidosis
T: temp decrease
C: citrate intoxication
H: hemolytic reaction
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9
Q

What does a type and screen determine?

A

ABO and Rh status and the presence of most commonly encountered antibodies

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10
Q

What does a type and crossmatch determine?

A

ABO and Rh status as well as adverse reaction to even low incidence antigens

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11
Q

Transfusion Thresholds

A

Not be based on Hgb/Hct levels alone

Generally symptomatic and Hgb of 6-10 g/dL

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12
Q

What hemoglobin level do studies indicate to target when providing blood products?

A

7-8 g/dL

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13
Q

By what factor does oxygen delivery exceed oxygen consumption?

A

Factor of 4

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14
Q

Compensatory Mechanisms for Delivery of Oxygen

A

Increased cardiac output
Rightward shift of the oxygen-hemoglobin dissociation curve
Increased oxygen extraction

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15
Q

Factors in the Decision to Transfuse Blood Products

A

Hub level
Clinical status
Co-morbidities
Patient preference

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16
Q

How long after an infusion can you check the Hgb/Hct levels?

A

15 minutes

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17
Q

When would you use FFP?

A

Clotting factors
Reverse warfarin
Massive transfusions
Liver disease

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18
Q

When do you transfuse platelets?

A

Low platelet counts that are symptomatic

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19
Q

Which blood type is the universal donor?

A

O negative

20
Q

Which blood type is the rarest?

A

AB negative

21
Q

Which blood types are the most common?

A

O positive

A positive

22
Q

Define Crystalloids

A

Solutions that contain small molecules and are able to pass through semipermeable membranes

23
Q

Why are isotonic solutions given?

A

Expand the ECF

24
Q

Why are hypotonic solutions given?

A

Reverse dehydration

25
Q

Why are hypertonic solutions given?

A

Increase ECF volume

Decrease cellular swelling

26
Q

Define Colloids

A

Solutions that contain high molecular weight proteins or starch

27
Q

Where is the final location of colloids?

A

Intravascular space

Too large to pass through the capillary walls

28
Q

What type of fluid are D5W, D10W, and D50W?

A

Crystalloid

29
Q

What type of fluid is albumin?

A

Colloid

30
Q

What type of fluid is dextran?

A

Colloid

31
Q

What type of fluid is saline?

A

Crystalloid

32
Q

What type of fluid are D5 1/2, D5NS, and D10NS)?

A

Crystalloid

33
Q

What type of fluid is hexastarch?

A

Colloid

34
Q

What type of fluid is ringer’s lactate (LR)?

A

Crystalloid

35
Q

Signs and Symptoms of Intravascular Depletion

A

Decreased BP
Flat jugular veins
Increased HR
Cool extremities

36
Q

Signs and Symptoms of Interstitial Fluid Depletion

A

Decreased skin turgor
Sunken eyeballs
Weight
+/- hemodynamic effects

37
Q

Final Location of 0.9% Saline

A

Intravascular space

Interstitial space

38
Q

Final Location of 5% Albumin and PRBCs

A

Intravascular space

39
Q

Which electrolytes are lost in sweat and exhaled water vapor?

A

None

40
Q

Which electrolytes are lost in the urine?

A

All of them

41
Q

Which patients do not need maintenance sodium or potassium?

A

Renal failure patients

42
Q

How is sodium regulated?

A

Thirst
ADH
Renal water handling

43
Q

Conditions that Cause Fluid Loss

A

GI
Renal
Vascular
Skin

44
Q

Conditions that Cause Fluid Gain

A

Iatrogenic
Heart failure
Liver failure
Kidney failure

45
Q

Why does liver failure cause fluid gain?

A

Decreased albumin which leads to decreased oncotic pressure

Emergency Medicine (17 decks)

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