Blood Transfusions Flashcards
Reasons for Transfusing
Excessive loss/Failure to produce
Products available
Whole Blood (rarely used) Red Cells Platelets Fresh Frozen Plasma Human Albumin Solution
What is Packed red cells
Sample of red cells packed to ensure haematocrit is ~70%
Stored at 4 degrees
1 unit raised haemalgobin 10 - 15 g/l (transfuse until ~80g/l)
Used to correct severe anaemia or in cases of blood loss
What are Platelets in transfusion terms
not usually needed unless bleeding or count is <20 x 10^9/l
used in cases of Bone marrow failure
Stored under agitation at 22 degrees
What is fresh frozen plasma
Used to Correct clotting defects e.g. DIC; Warfarin overdose where Vit K would be too slow; Liver disease; TTP
Expensive and still carries same risks as blood transfusions
What is Human Albumin Solution
stored as 4.5% or 20% and is used as a protein replacement
Following cases of abdominal paracentesis; Liver failrure; nephrotic syndrome
these are all things that create a hypoproteinaemic state - HAS can be given to these patients who are fluid overloaded without giving excess salt.
Acute Complications of Blood Transfusion (<24hr)
Acute Haemolytic reactions (ABO or Rh mismatch) Bacterial contamination
Fluid overload
Anaphylaxis
TRALI
Delayed Complications of Transfusion reactions (>24hr)
Infections (viruses, Hep B/C)
Iron overload
Graft-versus-host
Post transfusion purpura
Presentation andManagement of acute hameolytic reactions
e.g. ABO/Rh mismatch Rapid temperature increase Fall in BP Flushing Abdo/Chest pain Ozzing venepuncture sites DIC
Management STOP transfusion check identity and name on unit Inform haematology send unit + FBC, U&E, Clotting, cultures and urine Keep IV line open with 90.9% saline Treat DIC
Presentation and management of anaphylaxis
Bronchospasm
Cyanosis
Fall in BP
Soft tissue swelling
Management
STOP transfusion
maintain airway and give O2
Contact anaesthetist
Presentation and Management of Bacterial contamination
Rapid increase in Temp
Fall in BP
Rigors
Management STOP transfusion Check Id on unit Send unit + FBC, U&E, Clotting, Culture and urine Start Broad Spectrum Abx
Presentation and management of TRALI
Dyspnoea
Cough
CXR shows ‘White out’ appearance
ARDS dues to anti WBC Abs in Donorplasma
Management STOP transfusion Give 100% O2 Treat as ARDS Remove Donor From Panel
Presentation and Management of Non-Haemolytic Febrile Transfusion Reaction
Due to Recipient anti-HLA antibodies
Fevers,
Rigors
Chills
Management STOP or SLOW the transfusion give anti-pyretic monitor closely if recurrent, filter WBC
Presentation and Management of Allergic Reaction
Urticaria and Itch
Management
Slow or Stopr the transfusion
Chlophenamie 10mg - slow IV/IM
monitor closely
Presentation and Management of Fluid Overload
Dyspnoea Hypoxia Tachy invreased JVP Basal Creps
Management Slow or Stop the Transfusion Give O2 Give Diuretic (furosemide IV) Consider CVP line
