Blood transfusion Flashcards
3 times when we give red cells
Symptomatic anaemia
If significant bleeding anticipated, activate major haemorrhage protocol
Exchange transfusion
what does FFP contain?
all clotting factors
when do we give FFP
Given for coagulopathy with associated bleeding
what does cryoprecipitate contain?
Contains Factor VIII, VWF and fibrinogen
how long does a grouping test take?
5-10mins
how long does a full crossmatch take?
30-40mins
when do you declare code red?
Definition is a sudden and continuing blood loss of > 2 litres
when is major haemorrhage protocol activated
systolic BP <90
unresponsive to fluid bolus
suspected or confirmed haemorrhage
how does blood grouping occur in the lab?
test pt’s red cells with anti-A, B and D. Agglutination shows that a particular ag is on the red cell, no antigen shows the antigen is absent.
Tets the pt’s plasma with A cells and B cells. Agglutination shows that a particular antibody is in the plasma or serum. No agglutination shows the ab is absent
Main indications for platelet transfusion
Prevention and treatment of haemorrhage in patients with thrombocytopenia or platelet function defects.
Platelet transfusions are not indicated in all causes of thrombocytopenia and may indeed be contraindicated in certain conditions.
The cause of the thrombocytopenia should be established before a decision about the use of platelet transfusion is made.
specific indications for platelet transfusion
Active bleeding and platelet counts <50 x 109/L
Invasive procedures with platelet counts <50 x 109/L
Coagulopathy or bleeding in a critical site (i.e. CNS, lungs) may require transfusion at higher levels
Prophylaxis in patients with platelet count < 10 x 109/L and failure of platelet production (BMT, MDS, etc)
Platelet count 10-20 x 109/L with failure of platelet production and additional risk factors (fever)
Active bleeding in association with a platelet qualitative defect
indications for FFP
Bleeding due to multiple factor deficiencies:
DIC with bleeding – (NB not indicated in absence of bleeding)
Massive transfusion/surgical bleeding (with abnormal clotting tests due to dilution or consumption of clotting factors)
Clotting factor deficiencies where no concentrate exists (eg Factor V)
Plasma exchange in TTP
CIs for FFP
FFP should not be used as a volume expander or a protein supplement
FFP does not reverse the effects of heparin and is not indicated in patients with prolongations of their aPTT or PT due to lupus anticoagulants.
FFP should not be used prophylactically for expected massive transfusion or following cardiac bypass.
how do we categorise transfusion reactions
Acute: during or within 24 hours of a blood transfusion
Delayed: occurring more than 24 hours after transfusion
Immune-mediated
Non immune-mediated
example of acute transfusion reactions
Acute haemolytic Febrile non-haemolytic Urticarial Anaphylactic TRALI TACO Acute hypotensive
