Blood Products & IV Fluids Flashcards
Role of Blood in Oxygen Delivery
Blood delivers oxygen to tissues
Anemia impairs oxygen delivery
Oxygen delivery = cardiac output x arterial oxygen content
Risks of Transfusing Blood Products
Infection Allergic and immune transfusion reaction Volume overload Hyperkalemia Iron overload Surgical patients
Patients who are More Sensitive to Volume Overload
Elderly
Children
CHF
Patients who are More Sensitive to Hyperkalemia
Newborns
Renal failure
Massive transfusions
Patients who Develop Iron Overload
Large number of transfusions
Chronic Anemia
Define Massive Transfusion
Replacement of blood volume in a 24 hour period OR 50%+ of blood volume in 4 hours
Pneumonic for the Complications of a Massive Transfusion
PATCH
What does the pneumonic PATCH stand for in massive transfusions?
P: platelets decrease, potassium increases A: ARDS, acidosis T: temp decrease C: citrate intoxication H: hemolytic reaction
What does a type and screen determine?
ABO and Rh status and the presence of most commonly encountered antibodies
What does a type and crossmatch determine?
ABO and Rh status as well as adverse reaction to even low incidence antigens
Transfusion Thresholds
Not be based on Hgb/Hct levels alone
Generally symptomatic and Hgb of 6-10 g/dL
What hemoglobin level do studies indicate to target when providing blood products?
7-8 g/dL
By what factor does oxygen delivery exceed oxygen consumption?
Factor of 4
Compensatory Mechanisms for Delivery of Oxygen
Increased cardiac output
Rightward shift of the oxygen-hemoglobin dissociation curve
Increased oxygen extraction
Factors in the Decision to Transfuse Blood Products
Hub level
Clinical status
Co-morbidities
Patient preference
How long after an infusion can you check the Hgb/Hct levels?
15 minutes
When would you use FFP?
Clotting factors
Reverse warfarin
Massive transfusions
Liver disease
When do you transfuse platelets?
Low platelet counts that are symptomatic
Which blood type is the universal donor?
O negative
Which blood type is the rarest?
AB negative
Which blood types are the most common?
O positive
A positive
Define Crystalloids
Solutions that contain small molecules and are able to pass through semipermeable membranes
Why are isotonic solutions given?
Expand the ECF
Why are hypotonic solutions given?
Reverse dehydration
