Blood tranfusion Flashcards
What is non-haemolytic febrile reaction?
Presents with fever and chills
What is the management for non-haemolytic febrile reaction?
Slow or stop the transfusion
Give paracetamol
Monitor
What causes an acute haemolytic reaction?
ABO - incompatible blood secondary to human error
How do you treat an acute haemolytic reaction?
- Stop the transfusion
- Check the patient ID/name on blood product
- Second blood for direct Coombs testing, repeat typing and cross matching
- Fluid rescuscitation
How does acute haemolytic reaction present?
- Fever
- Abdominal pain
- Chills
How do you manage pruritis and urticaria with blood transfusion?
They are having a minor allergic reaction.
- Temporarily stop the transfusion
- Give an antihistamine
- Monitor
How do you manage anaphylaxis?
- Stop transfusion
- IM adrenaline
- ABC support
What is TACO?
Transfusion associated circulatory overload
What causes TACO?
- Excessive rate of transfusion
- Pre-existing heart failure
How does TACO present?
Pulmonary oedema
Hypotension
How do you manage TACO?-
- Slow or stop transfusion
2. Consider IV loop diuretic and oxygen
What causes transfusion related acute lung injury (TRALI)?
Pulmonary oedema secondary to increased vascular permeability caused by host neutrophils that become activated by substances in donated blood.
How does TRALI present?
Hypoxia Pulmonary infiltrates on CXR Fever Hypotension Within 6 hours of transfusion
How do you manage TRALI?
- Stop the transfusion
2. Oxygen and supportive care
What is the Hb threshold for tranfusion in ACS?
80g/L
What is the Hb tranfusion threshold in an otherwise well patient?
70g/L
How long do you give a unit of RBC over?
90-120 minutes
What is the platelet transfusion threshold when a patient has clinically significant bleeding eg haematemesis, melaena, epistaxis?
<30 x 10^9
What is the platelet transfusion threshold when a patient has severe bleeding, or bleeding at critical sites eg CNS?
<100 x 10^9
What is a significant risk with platelet transfusions?
Bacterial infections as they are stored at room temperature
If there is no bleeding, what is the threshold level for a platelet tranfusion?
<10 x 10^9
What are desired platelet levels before surgery/invasive procedure?
> 50 for most patients
50-75 if high risk of bleeding
100 if surgery is at a critical site
