Blood Transfusion Flashcards
What are packed RBCs used for and what is the threshold for their use?
- Treat symptomatic anaemia or blood loss.
2. Use if Hb <70g/L (1U raises by 10g/L)
What does fresh frozen plasma contain, what do you use it for, and how is it monitored?
- Contains all clotting factors.
- Give for coagulopathy with associated bleeding, liver disease, TTP, DIC with bleeding.
- Clotting screens to monitor
How many donors do transfused platelets come from and what are they used for?
- Comes from 4 donors
- Prevention and treatment of haemorrhage in patients with thrombocytopenia or platelet function defects.
- Only needed if Plt <50x10^9/L and active bleeding/invasive procedures.
What does cryoprecipitate contain, how much is given, and how is it monitored?
- Contains factor VII, vWF and fibrinogen.
- 2U given at once
- Monitor fibrinogen levels with clotting screens.
What antibodies and antigens do each of these blood groups have? 1. Group A 2. Group B 3. Group AB 4, Group O
- Anti-B antibodies and A antigens
- Anti-A antibodies and B antigens
- No antibodies and A and B antigens
- Anti-A and Anti-B antibodies and no antigens
What are the different types of transfusion reactions?
- Acute - during or within 24hrs of blood transfusion
- Delayed - occurring more than 24hrs after blood transfusion
- Immune-mediated or non-immune-mediated
What is this describing and how is it managed?
Blood transfusion. ABO incompatibility, most dangerous immunological complication. Agitation, rapid onset fever, hypotension, flushing, abdominal/chest pain, oozing venepuncture sites, DIC.
- Acute haemolytic reaction (present after small volume of transfusion)
- Stop transfusion
What is this describing and how is it managed?
Blood transfusion. Bronchospasm, cyanosis, hypotension, angioedema, urticaria.
- Anaphylaxis (present after small volume of transfusion)
2. Stop transfusion, IM adrenaline, chlorphenamine, hydrocortisone.
What is this describing and how is it managed?
Blood transfusion. Rapid onset fever, hypotension, rigors.
- Bacterial contamination
2. Stop transfusion, blood cultures, broad spectrum IV Abx.
What is this describing and how is it managed?
Blood transfusion. Due to interaction of donor leucocyte Abs and recipients leucocytes. 1-2 hours after transfusion. Dyspnoea, hypoxia, cough, white out on CXR.
- Transfusion related acute lung injury (TRALI)
2. Stop transfusion, admit to ICU, do not use diuretics.
What is this describing and how is it managed?
Blood transfusion. Rigors, fever, rash. 30-60 mins after start of unit.
- Non-haemolytic febrile reaction
2. Slow/stop transfusion, paracetamol +/- chlorphenamine.
What is this describing and how is it managed?
Blood transfusion. Urticaria, itch.
- Allergic reaction
2. Slow/stop transfusion, chlorphenamine
What is this describing and how is it managed?
Blood transfusion. Dyspnoea, hypoxia, tachycardia, raised JVP, basal crepitations.
- Transfusion associated circulatory overload (TACO)
2. Slow/stop transfusion, oxygen and diuretic.
What is the definition of a massive blood transfusion and what are the side effects?
- Replacement of an individuals entire blood volume within 24hrs.
- Hypocalcaemia, thrombocytopenia, hyperkalaemia, hypothermia.
What is the difference between vWF disease/platelet disorders, and coagulation factor deficiency in these areas?
- Site of bleeding
- Petechiae present?
- Ecchymoses (‘bruises’)
- Haemarthrosis/muscle bleeding
- Bleeding after cuts & scratches
- Bleeding after surgery/trauma
vWF disease/platelet disorder: 1. Skin, mucous membranes (epistaxis, UG tract, GI tract) 2. Yes 3. Small, superficial 4. Rare 5. Yes 6. Usually mild and immediate Coagulation factor deficiency: 1. Deep in soft tissues (joints, muscles) 2. No 3. Large, deep 4. Common 5. No 6. Often severe, may be delayed.
