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Gwen - Haematology > Blood Transfusion - Basics > Flashcards

Blood Transfusion - Basics Flashcards

1
Q

What is SHOT?

A

Serious Hazard of Transfusion

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2
Q

How long can you keep red blood cells for?

A

35 days

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3
Q

What happens to the potassium level in RBC components over time?

A

Increases

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4
Q

Why would you prefer to give neonates fresh blood?

A

Less of a potassium load than older blood, which is better for neonates

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5
Q

What can cause a “wrong blood in tube” scenario?

A
  • Sample from wrong patient
  • Unit collection errors
  • Failure of final bedside checking
  • Failure to request “special requirement” i.e. irradiated blood
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6
Q

What temperature are platelets kept at?

A

Room temperature

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7
Q

Why do BTS only take FFP from male donors?

A

Due to females developing unusual antibodies during pregnancy

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8
Q

What is the purpose of having 2 samples for crossmatch?

A

To make you go through the process of checking blood samples twice

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9
Q

How long are crossmatch tubes valid for?

A

3 days

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10
Q

Why is group O the universal red cell donor?

A

Lacks both A and B antigens, therefore doesn’t react with anti-A or anti-B antibodies in group A, group B and group AB plasma

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11
Q

What percentage of samples are rejected?

A

5%

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12
Q

When checking blood units prior to transfusion, what do you need to check?

A
  • No pack leakage
  • Transfusion port intact
  • No evidence of haemolysis
  • No gas/Discolouration/Clots
  • Donation number - pack matches label
  • Blood group - Pack compatible withlabel
  • Expiry date
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13
Q

When checking Patient against transfusion sample, what do you want to check?

A

IF ANY DISCREPANCY, do not transfuse

  • Name
  • DOB
  • T number
  • CHI/Hosp. Number

IF interrupted, stop and start again. Do not leave the patient until transfusion commenced

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14
Q

When labelling a sample for transfusion, what do you need to do?

A

Print patient details on the tube

  • Name
  • DOB
  • CHI/Hosp. Number
  • Ward
  • Gender
  • Date and time of sample

Apply T number labels to tube and wrist band if NHS highland

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15
Q

What are the main blood components?

A
  • Red Cells
  • Platelets
  • FFP
  • Cryoprecipitate
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16
Q

What temperature are red cells stored at?

A

4oC

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17
Q

What temperature are platelets stored at?

A

22oC

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18
Q

What temperature is FFP stored at?

A

-25oC

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19
Q

What is the universal red cell donor group?

A

Group O RhD negative

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20
Q

What is the universal FFP donor group?

A

Group AB RhD positive

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21
Q

Why is group AB the universal plasma donor?

A

AB people have no antibodies IN THEIR PLASMA as they have both A and B antigens on their red cells, therefore no antibodies are produced against them.

This is the same reasoning for the plasma being RhD positive

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22
Q

What antibodies will group A blood groups have?

A

Anti-B antibodies

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23
Q

How long can you store RBCs for?

A

36 days

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24
Q

How long can you keep Platelets?

A

5 days

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25
Q

How long can you keep FFP?

A

36 months

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26
Q

What moelcule makes up the A antigen?

A

N-acetyl-galactosamine

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27
Q

What molecule makes up the B-antigen?

A

D-galactose

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28
Q

Why do individuals produce antibodies against antigens not on their RBC?

A

Thought to be due to exposure to viral/bacterial/plant lectins in food which resemble these antigens, which they react against.

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29
Q

If someone had group A blood, what donor RBCs can be used?

A
  • Group O
  • Group A
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30
Q

If someone was group O, what donor RBCs can be used?

A

Group O only

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31
Q

If someone is group B, what donor RBCs can be used?

A
  • Group O
  • Group B
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32
Q

If someone has group AB blood, what RBC donor can be used?

A
  • Group O
  • Group A
  • Group B
  • Group AB
33
Q

If someone had group A blood, what donor FFP can be used?

A
  • Group AB
  • Group A
34
Q

If someone was group O, what donor FFP can be used?

A
  • Group O
  • Group A
  • Group B
  • Group AB
35
Q

If someone is group B, what donor FFP can be used?

A
  • Group AB
  • Group B
36
Q

If someone has group AB blood, what FFP donor can be used?

A
  • Group AB
37
Q

Why can you give RhD negative blood to an RhD positive person?

A

There is no foreign antigen on RhD blood, therefore no antibody will be stimulated

38
Q

Why can’t you give RhD positive to RhD negative individual?

A

Foreign antigen present on cells, therefore antibodies will be produced by RhD negative individual

39
Q

Can you give RhD negative to RhD positive individual?

A

Yes

40
Q

Can you give RhD positive to an RhD negative individual?

A

No

41
Q

What tests are done in crossmatching?

A
  • ABO grouping
  • RhD grouping
  • Antibody screening
  • Antibody ID
  • Select and label compatible components
42
Q

What blood group is the universal reciever for RBCs?

A

Group AB

43
Q

What blood group is the universal reciever for FFP?

A

Group O

44
Q

What does the second sample pre-transfusion requirement apply to?

A

Non-urgent, first time blood component requests

45
Q

What does the second sample pre-transfusion requirement not apply to?

A
  • Urgent blood requests
  • Requests for infants up to 12 months of age
  • Requests for patients whose blood group is already known to the lab
46
Q

What is important to remeber about the second sample pre-transfusion requirement?

A

Take each sample at different time points

47
Q

If blood was urgently required, what blood is available?

A

Major haemorrhage protocol

  • 6 units red cells
  • 4 units FFP (cryoprecipitate?)
  • 1 unit platelets
48
Q

If you required urgent crossmatch, how many samples would you need to send to the lab?

A

1 sample

49
Q

If you required urgent transfusion, how quickly can samples sent to the lab be turned around?

A

25-30 minutes

50
Q

What testing is done on a sample sent to the labs for urgent transfusion?

A
  • ABO and RhD
  • Antibodies are not tested - screen done retrospectively
51
Q

If you requested an elective transfusion from the labs and the patient was already known to the laboratory, how amny samples would you need to send?

A

1 sample

52
Q

If you required elective transfusion for a new patient, how many samples would you send to the lab?

A

2 samples

53
Q

How quickly should you transfuse RBCs?

A

Over 2-4 hrs

54
Q

How quickly should you transfuse platelets?

A

20-60 minutes

55
Q

Are bloods issued for a group and save sample?

A

No - only makes patient aware to the lab so if needed in the future only need one sample

56
Q

What volume is the minimum volume for a crossmatch/group and save sample for it not to be rejected?

A

2 ml

57
Q

If someone has post-op fluid resuscitation, what happens to the haematocrit?

A

Decreases - artficially diluted by resus fluids

58
Q

What proportion total blood volume (approx 5L) of blood is red cells?

A

40% - Hct 4.0

59
Q

What should you never do with regard to treating somone based on haemoglobin results?

A

Treat solely based on these results - need to look at:

  • Hct
  • Normal Hb based on age sex and size
  • Rate of loss
  • Ongoing loss
  • Risk of symptoms
  • Ability to compensate
  • Observable signs
60
Q

If someone was losing blood from a perforated gastroduodenal artery, and another person is losing blood from the brachial artery, which person is likely to require transfusion?

A

Individual with gastroduodenal ulcer - brachial artery can be stopped relatively easily compared to ulcer, therefore ulcer will have relatively more loss and will be more likely to require transfusion

61
Q

When would you consider asking a patient for autologous blood?

A

Those with a lot of antibody’s for whom matching will be very difficult- e.g. multipregnancy

62
Q

What is intra-operative cell salvage?

A

A medical procedure involving recovering blood lost during surgery and re-infusing it into the patient. It is a major form of autotransfusion

63
Q

What are contraindications to IOCS?

A
  • Cancer
  • Abdominal surgery - risk of infection
  • Debris
64
Q

When would you consider tranfusing someone who was anaemic?

A

When they became symptomatic

65
Q

How would you determine how many units of blood to give someone?

A

Based on clinical signs/symptoms - give single units and assess whether sympatomatic. If remains symptomatic, give another single unit and reassess

66
Q

How long after blood has been removed from the fridge do you have to transfuse blood?

A

4 hours maximum after removal from refrigeration** to the **END of transfusion.

This is to reduce the risk of septic reactions due to bacteria proliferting in blood once it has warmed

67
Q

What does the direct coombs measure for?

A

Autoimmun ehaemolytic anaemia

HDFN

Haemolytic thransfusion reactions

68
Q

What does the indirect coombs measure for?

A

Cross matching

Alloantibodies

69
Q

Is haemolytic disease o the new born extra or intravascular haemolysysi?

A

Extravascular haemolysis

70
Q

Indications for red cell transfusion

A
  • To prevent or correct severe acute anaemia (<70g/dL)
  • To imrpove quality of life in a patient with uncorrectable anaemia eg bone marrow failure
  • To prepare a patint for surgery (rare! cardiac disease)
  • To reverse damage caused by patient’s own cells - sickle cell disease
71
Q

Alternative to red blood cell transfusion

A
  • Fix iron deficiency
  • EPO
  • Intraoperative cell salvage
72
Q

Indications for platelet transfusion

A
  • Prophylactically to stop bleeding
  • Abnormlaities of platelet function
  • Cardiopulmonary bypass surgery (damages the platelets)
  • DIC
  • Bone marrow failure
73
Q

Indications for FFP use

A
  • Replacement of coag deficiencies where a specific or combine factor concentrate is unavailble eg facor 5
  • DIC in the presence of bleed and abnormal coagulation
  • TTO (autoantibody against von willibrand protein therefore spontaneous platelet plugs. PLASMA EXCHANGE IS LIFE SAVING.
74
Q

What is cryoprecipitate

A

A precipitate that froms by controlled thawing of FFP at 4 degrees. Difference between FFP and cryo is that cryo is pooled units from several FFPs…So instead of giving like 10 units of FFP you can just give 1 pack of cryo and get the same effect. So cryo basically used in massive transfusion protocol. (Cryo was used for Factor VIII and vWF deficiency before concentrates became available.)

75
Q

What factors does FFP have?

A
76
Q

What is used to reverse warfarin?

A

Vit K and FFP

77
Q

Whats brought in a massive transfusion policy?

A

6 units red cell, 4 FFP

78
Q

How many mls in one unit of red cells?

A

440ml

Gwen - Haematology (33 decks)

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