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Hematological Emergencies > Blood Typing And Cross Match > Flashcards

Blood Typing And Cross Match Flashcards

1
Q

Cross matching

A

Detects hemolytic or agglutination reactions in a mixture of serum and cells from two different individuals

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2
Q

Importance of blood typing

A
  • RBCs to be typed with specific typing reagents
  • Reduction of transfusion reactions
  • Longer lasting benefits in-patient from RBCs and efficient utilization of donor pool
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3
Q

Feline blood types

A

A, B and AB

  • No universal blood types
  • Has naturally occurring allo-antibodies
  • can be fatal if given wrong blood type
  • Blood type B cats can have fatal reaction to Type A blood
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4
Q

What blood type are DSH usually and what is the percentage?

A

*99% DSH are Type A

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5
Q

What cat breeds have 0% chance of Blood Type B?

A

*Siamese, Tonkinese, Burmese, Russian Blue

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6
Q

What are the most common cat breeds with blood type B?

A

Exotic breeds, Abyssinian, Cornish and Devon Rex

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7
Q

What cat blood type is rare?

A

Blood type AB

Therefore rare blood donors

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8
Q

What blood type should be used for cat blood type AB if blood AB is not available?

A

Type A is the best choice

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9
Q

How many Canine blood types are there?

A

About 13 types

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10
Q

What determines the canine blood types?

A

Antigens adhered to the surfaces of the red cells using the nomenclature Dog Erythrocyte Antigen (DEA)

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11
Q

What canine blood type commonly cause an antigen-antibody reaction?

A

1.1, 1.2 and 7

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12
Q

What percentage of dogs are DEA 1.1 positive?

A

40%

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13
Q

What is the canine universal blood type?

A

DEA 1.1 negative

*Giving blood type DEA 1.1 negative will reduce or eliminate first time transfusion reactions

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14
Q

Blood typing

A

Recommended before any blood transfusion are administered

  • Kits available for in house test
  • small amount of anticoagulant blood
  • based on agglutination reaction that occurs within 2 mins when DEA 1.1 positive RBCs interact with antibodies specific to DEA 1.1
  • Outside blood typing labs available in US
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15
Q

Cross matching

A
  • Used to detect serum or plasma incompatibilities among the recipient and donor
  • Should always be used in patients receiving multiple blood transfusions on an untyped recipient or when transfusion history is unclear
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16
Q

What happens when transfusion of incompatible cells occurs?

A
  • Immune response triggered
  • detected in cross match within 5-7 days post transfusion
  • Once antibodies formed
  • will persist clinically for years
17
Q

What are the three components to cross matching?

A

Major, Minor and auto control

Major: donor red cells mixed with recipient plasma
Minor: donor plasma mixed with recipient RBCs
Auto control: recipient red cells mixed with recipient plasma

18
Q

Transfusion reactions signs

A

Tachypnea, tachycardia, fever, lethargy, facial swelling, vomiting, diarrhea, change in mentation

19
Q

How are transfusion reaction categorized?

A
  • Immune mediated or non-immune-mediated
  • Acute (within 24 hours) = MOST FEARED as can be fatal
  • Delayed (days to years)
20
Q

When are acute immunological reaction seen?

A

Administration of blood type A blood to a blood type B cat

21
Q

What does antibodies directed against foreign red cell cause?

A

Acute hemolysis, anaphylaxis or shock reaction

22
Q

What does a delayed immune mediated response cause?

A
  • A shortened cell life span

* Foreign RBC removed from circulation 7-10 days post transfusion

23
Q

What is a non-hemolytic immunological reaction

A

*antibody response to WCS, platelets or plasma proteins

24
Q

What would you expect to see in non-hemolytic immunological reactions?

A
  • Fever
  • Hypersensitivity
  • Allergic like reactions: urticaria (hives), pyrexia, pruritius (itch), hypotension
  • seen within the first mins or hours from the time of transfusion
25
Q

What are some of the factors responsible for non-immune mediated transfusion reactions?

A
  • Improper collection, processing, or administration of blood products
  • Over transfusion or volume overload - most common
  • Signs: vomiting, retching, vocalization, dyspnea, tachypnea or pulmonary edema
26
Q

Hemolysis of blood products

A
  • use of small size bore needle
  • overheating
  • freezing
  • dilution of RBCs with hypotonic solution
  • prolonged storage
  • bacterial contamination
27
Q

What does transfusion of hemolyzed blood products cause?

A

Reduces benefits of RBCs, fever or DIC

28
Q

What does transfusion of blood products containing micro-clots?

A
  • Pulmonary edema

* DIC or thrombosis

29
Q

What are the signs of bacterial growth in blood products?

A
  • Dark discoloration of RBC products
  • Clumped cells
  • Air bubbles
30
Q

What does transfusion of contaminated blood products cause?

A

*Acute signs of septic shock : fever, hypotension, hemolysis, vomiting, DIC

31
Q

Treatment for transfusion reaction

A
  • Stop transfusion
  • Symptomatic Tx to alleviate signs
  • Vol. overload: discontinue transfusion or at a lower rate, diuretic use (furosemide) and oxygen supplementation if dyspnea/pulmonary edema
  • Acute hemolysis, shock or anaphylactic reaction: fluid support, ventilation, oxygen, epinephrine and glucocorticoids
  • Urticaria, pruritus, edema: Tx with diphenhydramine, dexamethasone or prednisolone
  • mild febrile reaction: no Tx
  • Severe febrile reaction: antipyretics and fluid support
32
Q

Administration and handling of whole blood or blood components

A
  • should not be given solely based on hematocrit or hemoglobin levels
  • components should be given within 4hrs
  • reduces bacterial growth
  • use blood filter to remove fibrin clots, debris, platelet aggrates during collection and storage
33
Q

Initial rate of transfusion

A

1 ml/kg/hr

Or

2ml/lb/hr

Reevaluate within 1/2 hour

  • if normal then give the rest within 4 hours
  • Do not give with medications
  • Only use with 0.9%NaCl
  • Room temperature for neonate or hypothermic Animal
  • Large animals breeds will not be compromised by cool products
34
Q

How long can packed cells and whole blood be stored for in the refrigerator?

A

25 days

35
Q

What temperature of water bath should be used to defrost plasma, FFP and cryoprecipitates?

A

In cold water bath

Hematological Emergencies (3 decks)

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