Blood transfusion

Question 1

4 main blood groups

Answer 1

O, A, B and AB

There is also another blood group called D also called Rhesus (Rh)

Question 2

Antibody

Answer 2

Approx 1 in 15 patients develop an antibody in the plasma after exposure during transfusion/pregnancy
These antibodies are not caused because of an illness or infection
They are not harmful to the patient and will not affect their health
They are not infectious and cannot be caught by other people
ANTIBODIES WILL BE OPPOSITE TO BLOOD GROUP
A blood group - ANTI B
B blood group - ANTI A
AB blood group - NO ANTIBODIES
O blood group - ANTI A & ANTI B

Question 3

Antigens

Answer 3

Found on red cells
Only for positive rhesus
Determine blood groups - Antigens on red cells define the blood type
E.g. A antigen - group A

A blood group - A ANTIGEN
B blood group - B ANTIGEN
AB blood group - A & B ANTIGEN
O blood group - NONE

Question 4

Blood group rules

Answer 4

Antibodies attack antigens of the same letter. For example Anti A attack A antigen
Do not give a patient new antigens - Group a give group a and group o red cells. A Rhd negative

Question 5

Universal blood donor

Answer 5

O negative

Question 6

Anti D

Answer 6

Anti D made by ‘negative people’. Only on exposure to D - positive red cells
4 months after birth comes into the hospital
To test for Anti B
As the baby has been exposed to air and can develop Anti B
Antigens stimulate to make antibodies

If she is exposed to positive cells that have the antigen she will then make the anti D
Anti D is the strongest, Anti K is the deadliest

500 IU each dose - @ 28 weeks & 34 weeks & postnatal
1500 IU - 32 - 34 weeks

Question 7

Why is Anti D used in pregnancy?

Answer 7

Anti D in the 1st pregnancy so their body won’t makes it’s own Anti D
When the red cells cross over the placenta the women will already have anti D
Anti d attaches to red cells and clears red cells from the body. To prevent mum making her own anti D. Given to Rhesus negative mum. Only people who have potential to make anti D. If mum makes her own Anti D has the potential to go into the placenta and affect baby’s circulation. Given at 28 weeks. Anti D given early if any damage occurs that can cause baby’s cells to cross over e.g. a fall

Question 8

Plasma

Answer 8

Fresh frozen plasma needs to be ABO compatible but not RhD compatible

Question 9

DAT

Answer 9

Used to detect haemolytic disease of the fetus and newborn
Mother antibody cross the placenta and bind to baby cells
When mixed with antihuman globulin baby/fetus cell agglutinate
Test is repeated until you see no more of moms anti D in baby

Question 10

Postnatal - Keilhauer betke test

Answer 10

Anti D given in postnatal within 72 hours
Used to detect fetal maternal haemorrhage
Samples are taken 30-45 minutes after birth
HgbF being resistant to teh acid remains intact whereas HgBA
Fetal red blood cells are rose pink in colour
Determine how many cells and find out volume of baby’s blood in mum
0.1 mls of baby blood will cause mum to make a antibody

Question 11

FBC - Full blood count

Answer 11

to find out their blood group and to see if the have antibodies and then to save the serum incase of blood transfusion

Question 12

Rules of taking blood from the fridge

Answer 12

4 hours maximum to transfer
0 - time taken from fridge
4 hours - when transfusion must end
In order to put blood to fridge you have 30 mins
Or 30 minutes to give it
Blood expires in 4 hours and doesnt not to be given in 4 hours

Question 13

Red blood cells

Answer 13

Red cells are made in your bone marrow
EPO in kidney tells bone marrow to make red blood cells
You have to have enough iron in your blood to make a complete a red blood cells - each has four molecule of iron

Instead of giving red cells you can give EPO
Higher need for red cells women who are pregnant
Folic acid and Vitamin B12 are a raw ingrediant for making red blood cells
If Hb is more than 8g/ dl patient does not need transfusion unless they have symptoms
If it is less than 8g they may nee transfusion